Imatinib-induced cytogenetic remission in chronic eosinophilic leukaemia.

摘要

Patients presenting with peripheral blood eosinophilia may represent a difficult diagnostic challenge. Reactive causes including drug reaction, parasitic infection, various malignancies and vasculitis all need to be considered. The recently identified abnormality at chromosome 4q12 in hithertolabelled,idiopathic hypereosinophilic syndrome cases is important to consider because of effective therapy.A 46-year-old man presented with a 1-week history of chest pain, cough and extreme breathlessness, on a background of 3 months of increasing lethargy. Investigation confirmed an eosinophilia of 20 x 10~9/L, otherwise normal haematology indices and renal impairment (serum creatinineof 140 mumol/L). The electrocardiogram showed inferolateralT wave inversion, and the troponin T was raised. Coronary angiography was normal; however, echocardiographyshowed global systolic dysfunction, reduced left ventricular ejection fraction (LVEF; 43%) and biventricular thickening. Myocardial scarring and eosinophilic infiltratewere evident on endomyocardial biopsy. Imaging and functional pulmonary tests were normal.