ORIGINAL RESEARCH article
Front. Med.
Sec. Hematology
This article is part of the Research TopicCoagulation, Inflammation, and Healing: Defining the Intricate Network for Clinical InnovationView all 5 articles
Acute Multisystemic Thromboembolism Manifesting as Cerebral Infarction, Myocardial Injury, and Quadriparesis: A Novel Triad of Idiopathic Hypereosinophilic Syndrome
Provisionally accepted
- Renmin Hospital, Hubei University of Medicine, Shiyan, China
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Background:Hypersegmented Eosinophil Syndrome (HES) is a rare myeloproliferative condition with several clinical symptoms. Idiopathic HES presenting with acute, contemporaneous multisystem thrombotic episodes is extremely unusual, making clinical detection difficult and increasing the risk of misdiagnosis. Case presentation:This paper describes the case of a 69-year-old male patient with a history of coronary heart disease and hypertension, who was admitted for "dizziness accompanied by discomfort in the left shoulder and precordial region." The patient was initially diagnosed with posterior circulation ischaemia, but quickly developed a clinical triad of acute cerebral infarction (confirmed by cranial MRI), non-ST-segment elevation myocardial infarction (confirmed by progressively rising cardiac markers and ECG), and acute quadriplegia (muscle strength 0-3). Laboratory tests revealed significant peripheral blood eosinophilia (43.4%). Coronary CT scans ruled out acute in-stent restenosis. Bone marrow aspiration and genetic testing ruled out other clonal anomalies, resulting in a diagnosis of "idiopathic hypereosinophilic syndrome." Discussion:This case report describes a novel clinical situation in which an acute thromboembolic triad (cerebral infarction, cardiac damage, and quadriplegia) is the first presentation of idiopathic HES. It demonstrates that eosinophil-mediated hypercoagulability is the primary pathogenic mechanism behind multisystem embolism. Conclusion:Prompt blood tests to assess eosinophil counts remain critical for early identification of HES, especially in the absence of usual clinical history. Early and strong glucocorticoid treatment efficiently reduces eosinophil levels and improves prognosis.
Keywords: Hypereosinophilic Syndrome, Eosinophil-mediated microvascular thrombosis, acute myocardial infarction, Cerebral Infarction, Quadriparesis, Corticosteroid therapy, Idiopathic hypereosinophilic syndrome, Multisystemic thromboembolism
Received: 13 Aug 2025; Accepted: 11 Nov 2025.
Copyright: © 2025 Bai, Shang, Liao and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yong Bai, 317024561@qq.com
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