Rapidly evolving asymptomatic eosinophilia in a patient with lung adenocarcinoma causes cognitive disturbance and respiratory insufficiency: Case report

Lo,Cheng-Hsiang; Jen,Yee-Min; Tsai,Wen-Chiuan; Chung,Ping-Ying; Kao,Woei-Yau

doi:10.3892/ol.2012.1020

Rapidly evolving asymptomatic eosinophilia in a patient with lung adenocarcinoma causes cognitive disturbance and respiratory insufficiency: Case report

Authors:
- Cheng-Hsiang Lo
- Yee-Min Jen
- Wen-Chiuan Tsai
- Ping-Ying Chung
- Woei-Yau Kao
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Affiliations: Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taiwan, R.O.C, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taiwan, R.O.C, Division of Hematology and Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taiwan, R.O.C
Published online on: November 9, 2012 https://doi.org/10.3892/ol.2012.1020
Pages: 495-498

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Abstract

Paraneoplastic eosinophilia is an unusual manifestation that usually remains asymptomatic. In this report, we presented the case of an 82-year-old patient with poorly differentiated lung adenocarcinoma and asymptomatic eosinophilia. The patient's condition worsened rapidly over a week, with episodes of cognitive disturbance, shortness of breath and acute kidney dysfunction. These symptoms were associated with a 4-fold increase in circulating eosinophil counts. The poor condition hindered further anticancer treatment. Treatment of the eosinophilia with corticosteroids and hydroxyurea significantly reduced circulating eosinophil counts to below the initial levels. Results of this case report suggested that lung cancer patients should be monitored closely for rapidly worsening symptoms of cognitive disturbance and respiratory insufficiency as signs of life-threatening asymptomatic eosinophilia, in order to initiate corticosteroid treatment.

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1.	Jameson JL and Johnson BE: Paraneoplastic syndromes: endocrinologic/hematologic. Harrison’s Principles of Internal Medicine. Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL and Loscalzo J: 17th edition. McGraw Hill Medical; New York, NY: pp. 617–622. 2008
2.	Brito-Babapulle F: The eosinophilias, including the idiopathic hypereosinophilic syndrome. Br J Haematol. 121:203–223. 2003. View Article : Google Scholar : PubMed/NCBI
3.	Zhu YL, Tong ZH, Jin ML and Wang C: Lung cancer with marked blood eosinophilia: case report and literature review. Zhonghua Jie He He Hu Xi Za Zhi. 32:369–372. 2009.(In Chinese).
4.	Pandit R, Scholnik A, Wulfekuhler L and Dimitrov N: Non-small-cell lung cancer associated with excessive eosinophilia and secretion of interleukin-5 as a paraneoplastic syndrome. Am J Hematol. 82:234–237. 2007. View Article : Google Scholar : PubMed/NCBI
5.	Verstraeten AS, De Weert A, van Den Eynden G, Van Marck E, Snoeckx A and Jorens PG: Excessive eosinophilia as paraneoplastic syndrome in a patient with non-small-cell lung carcinoma: a case report and review of the literature. Acta Clin Belg. 66:293–297. 2011.PubMed/NCBI
6.	Andriamanantena D, Boye T, Gervaise A, Vieu C, Splingard B, Dot JM, Veran Y, et al: An unusual paraneoplastic manifestation in lung cancer: eosinophilic erythroderma. Rev Pneumol Clin. 65:32–35. 2009.PubMed/NCBI
7.	Watanabe M, Ono K, Ozeki Y, Tanaka S, Aida S and Okuno Y: Production of granulocyte-macrophage colony-stimulating factor in a patient with metastatic chest wall large cell carcinoma. Jpn J Clin Oncol. 28:559–562. 1998. View Article : Google Scholar : PubMed/NCBI
8.	Sawyers CL, Golde DW, Quan S and Nimer SD: Production of granulocyte-macrophage colony-stimulating factor in two patients with lung cancer, leukocytosis, and eosinophilia. Cancer. 69:1342–1346. 1992. View Article : Google Scholar : PubMed/NCBI
9.	Nakada T, Sato H, Inoue F, Mizorogi F, Nagayama K and Tanaka T: The production of colony-stimulating factors by thyroid carcinoma is associated with marked neutrophilia and eosinophilia. Intern Med. 35:815–820. 1996. View Article : Google Scholar : PubMed/NCBI
10.	Anagnostopoulos GK, Sakorafas GH, Kostopoulos P, Margantinis G, Tsiakos S, Terpos E, Pavlakis G, et al: Disseminated colon cancer with severe peripheral blood eosinophilia and elevated serum levels of interleukine-2, interleukine-3, interleukine-5, and GM-CSF. J Surg Oncol. 89:273–275. 2005. View Article : Google Scholar : PubMed/NCBI
11.	Kato H, Kohata K, Yamamoto J, Ichikawa S, Watanabe M, Ishizawa K, Ichinohasama R, et al: Extreme eosinophilia caused by interleukin-5-producing disseminated colon cancer. Int J Hematol. 91:328–330. 2010. View Article : Google Scholar : PubMed/NCBI
12.	Matsumoto S, Tamai T, Yanagisawa K, Kawamura S and Fujita S: Lung cancer with eosinophilia in the peripheral blood and the pleural fluid. Intern Med. 31:525–529. 1992. View Article : Google Scholar : PubMed/NCBI
13.	Ogbogu PU, Bochner BS, Butterfield JH, Gleich GJ, Huss-Marp J, Kahn JE, Leiferman KM, et al: Hypereosinophilic syndrome: a multicenter, retrospective analysis of clinical characteristics and response to therapy. J Allergy Clin Immunol. 124:1319–1325. 2009. View Article : Google Scholar : PubMed/NCBI
14.	Tefferi A, Patnaik MM and Pardanani A: Eosinophilia: secondary, clonal and idiopathic. Br J Haematol. 133:468–492. 2006. View Article : Google Scholar : PubMed/NCBI
15.	Gotlib J: World Health Organization-defined eosinophilic disorders: 2011 update on diagnosis, risk stratification, and management. Am J Hematol. 86:677–688. 2011. View Article : Google Scholar : PubMed/NCBI
16.	Srinivasan A, Lavanya R and Sankar J: Steroid-unresponsive hypereosinophilic syndrome. Ann Trop Paediatr. 31:273–277. 2011. View Article : Google Scholar : PubMed/NCBI
17.	Iwasaki K, Torisu M and Fujimura T: Malignant tumor and eosinophils: Prognostic significance in gastric cancer. Cancer. 58:1321–1327. 1986. View Article : Google Scholar : PubMed/NCBI
18.	Teoh SC, Siow WY and Tan HT: Severe eosinophilia in disseminated gastric carcinoma. Singapore Med J. 41:232–234. 2000.PubMed/NCBI
19.	Chang WC, Liaw CC, Wang PN, Tsai YH and Hsueh S: Tumor-associated hypereosinophilia: report of four cases. Changgeng Yi Xue Za Zhi. 19:66–70. 1996.PubMed/NCBI
20.	Reddy SS, Hyland RH, Alison RE, Sturgeon JF and Hutcheon MA: Tumor-associated peripheral eosinophilia: two unusual cases. J Clin Oncol. 2:1165–1169. 1984.PubMed/NCBI
21.	El-Osta H, El-Haddad P and Nabbout N: Lung carcinoma associated with excessive eosinophilia. J Clin Oncol. 26:3456–3457. 2008. View Article : Google Scholar : PubMed/NCBI