case_images: PMC10285082_01
case_images: Laboratory characteristics of the patients at diagnosis. (A) Morphological analysis of patient #1 revealed bone marrow with 23.5% eosinophils and granulocytic proliferation (Wright-Giemsa staining x1000). (B) Bone marrow biopsy of patient #1 showed hematopoiesis with marked eosinophil infiltration (Hematoxylin-eosin staining x400). (C) Bone marrow morphology of patient #2 showed hypercellular marrow with marked eosinophilia (41% eosinophils) (Wright-Giemsa staining x1000). (D) Bone marrow biopsy of patient #2 revealed granulocytic proliferation and significantly increased eosinophils. (Hematoxylin-eosin staining x100).
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case_images: PMC10285082_02_fphar-14-1095737-g001.jpg
case_images: F1
case_images: Figure 1C, bone marrow smears revealed hypercellular morphology with marked eosinophilia (41% eosinophils). Flow cytometric immunophenotyping and bone marrow biopsy confirmed eosinophilia (Figure 1D).
case_images: Variation curve of patient #1's absolute eosinophil count (AEC) over time and different treatments. The curve demonstrated the change of the patient's PB eosinophil count over time and adjustments of therapeutic regimen. It declined rapidly after first initiation of prednisolone (PREDNIS) and rose gradually since January 2020. Application of methotrexate (MTX), mofetil tablets (MMF), Imatinib, and Interferon-alpha (IFN-alpha) did not bring down the AEC. Omalizumab was used in September 2021, after which his PB eosinophil count decreased rapidly and reached 0.8 x 109/L in January 2022. It has stayed around 1.0 x109/L for 17 months. Prednisolone was tapered to 2.5 mg/d.
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case_images: F2
case_images: The rashes faded away and AEC returned to normal in 1 month (Figure 2). Frustratingly, his AEC began to rise again and exceeded the normal range in January 2020 (Figure 2). AEC was examined monthly since the first injection. As is shown in Figure 2, it decreased from 4.31 x 109/L to 2.78 x 109/L after the first month.
case_images: PMC10285082_02
case_images: Laboratory characteristics of the patients at diagnosis. (A) Morphological analysis of patient #1 revealed bone marrow with 23.5% eosinophils and granulocytic proliferation (Wright-Giemsa staining x1000). (B) Bone marrow biopsy of patient #1 showed hematopoiesis with marked eosinophil infiltration (Hematoxylin-eosin staining x400). (C) Bone marrow morphology of patient #2 showed hypercellular marrow with marked eosinophilia (41% eosinophils) (Wright-Giemsa staining x1000). (D) Bone marrow biopsy of patient #2 revealed granulocytic proliferation and significantly increased eosinophils. (Hematoxylin-eosin staining x100).
case_images: fphar-14-1095737-g001.jpg
case_images: PMC10285082_02_fphar-14-1095737-g001.jpg
case_images: F1
case_images: Figure 1C, bone marrow smears revealed hypercellular morphology with marked eosinophilia (41% eosinophils). Flow cytometric immunophenotyping and bone marrow biopsy confirmed eosinophilia (Figure 1D).