ISSN 1941-5923

Logo



Welcome to the American Journal of Case Reports

Clinical case reports are an invaluable first-hand source of evidence in medicine and a tool most often used in practice to exchange information and generate a more expanded search for evidence. In addition to the “evidence of what happened”, single or multiple cases are an important basis for further and more advanced research on diagnosis,  treatment effectiveness, causes and outcomes of disease. However limited their... read more


Published: 2014-09-17

In-Stent Restenosis Exacerbated by Drug-Induced Severe Eosinophilia after Second-Generation Drug-Eluting Stent Implantation

Hiroki Yagi, Eisuke Amiya, Jiro Ando, Masafumi Watanabe, Koichi Yanaba, Masako Ikemura, Masashi Fukayama, Issei Komuro

(Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan)

Am J Case Rep 2014; 15:397-400

DOI: 10.12659/AJCR.891106


Background: In-stent restenosis (ISR) is still a recognized clinical problem in the era of drug-eluting stent (DES). Some previous studies have suggested that circulating eosinophils play an important role in both restenosis and thrombosis after DES implantation. However, the contribution of eosinophils to the pathogenesis of ISR has not yet been concisely clarified.
Case Report: We present the case of an 83-year-old male Japanese patient with ISR exacerbated by drug-induced severe eosinophilia. He had previous histories of coronary stent implantations by DES and was referred to our hospital because of erythema with severe eosinophilia (maximum was 6500/μl [48% of total white blood cell count]). Around the same time, the patient developed ISR, for which a stent was deployed 2 years earlier. Arterial wall injury due to the increase in circulating eosinophils was verified in several findings, such as the increase of D-dimer and brain natriuretic peptide. In addition, the histology of the resected tissue from erythema demonstrated that the nuclei of endothelial cells were swollen where eosinophils and lymphocytes heavily infiltrated into the extravascular space, suggesting the presence of vascular injury. This injury due to the increase in circulating eosinophils may have a marked impact on the pathologic process of ISR in DES implantation.
Conclusions: Just a few anecdotal reports are available of ISR occurring in the setting of hypereosinophilia. The clarification of the mechanism in this patient provides a new effective therapeutic strategy against ISR in the setting of DES implantation.

Keywords: Coronary Restenosis, drug-eluting stents, Eosinophilia



Related Articles (0)

Coming Soon...

Published: 2014-09-14

Severe Hypercalcemia Complicating Recovery of Acute Kidney Injury due to Rhabdomyolysis


Lisa Aimee Hechanova, Seyed Ali Sadjadi

Am J Case Rep 2014; 15:393-396

DOI: 10.12659/AJCR.891046

Published: 2014-09-11

Endobronchial Hamartoma as a Cause of Pneumonia


Tsuyoshi Oguma, Hiroto Takiguchi, Kyoko Niimi, Hiromi Tomomatsu, Katsuyoshi Tomomatsu, Naoki Hayama, Takuya Aoki, Tetsuya Urano, Natsuko Nakano, Go Ogura, Tomoki Nakagawa, Ryota Masuda, Masayuki Iwazaki, Tadashi Abe, Koichiro Asano

Am J Case Rep 2014; 15:388-392

DOI: 10.12659/AJCR.890869