慢性ITPで経過観察中，血小板数も増加したHypereosinophilic Syndrome例

抄録

A 1-year-2-month old boy was admitted to the Tokushima University Hospital because of petechiae and nasal bleeding. The peripheral blood showed a decrease in platelets and the bone marrow showed an increase in immature megakaryocytes. He was diagnosed as idiopathic thrombocytopenic purpura (ITP). Therapy with prednisolone for 2 months resulted no hematological improvement. After discharge he attended the outpatient clinic about once a month for hematological examinations, but thrombocytopenia persisted.
At the age of 4 years he complained fatigability. Physical examination revealed no remarkable abnormalities. The peripheral blood revealed an increase in mature eosinophils and platelets. The bone marrow was entirely normal except for an increase of mature eosinophils. Repeated examination of stools did not reveal any ova and parasites. The sedimentation rate was 51 mm/hr and rheumatoid factor was positive. Serum immunoelectrophoresis disclosed a marked increase of IgE-gloubulin. A chest X-ray film showed infiltrates at right lung fields. The number of CFU-EO in the patient was greater than that of the healthy subjects, and the production of EO-CSF produced by mononuclear cells was not increased.
Prednisolone therapy resulted in an disappearance of his complaints, and the abnormal results in laboratory examinations gradualy improved by the age 6 years.
This patient with hypereosinophilic syndrome are considered to be unique because of simultaneous increase of platelets in the clinical course of chronic ITP.