Resolved Hypereosinophilic Syndrome and Immune Thrombocytopenic Purpura in Ulcerative Colitis Patients Post Colectomy: A Case Series and Literature Review

Figures & data

Table 1 Summary of Case Reports in Literature of UC and HES

Author	Year	Age - Sex	Co-Morbidities with UC	Organ Infiltration	Treatments Received	HES Outcome
Kane^Citation28	1977	41, female	HES Chronic liver disease Auto-immune thyroiditis	None	Sulphasalazine, betamethasone enema	Resolved
Awano et al^Citation25	2011	23, female	HES CEL without PDGFRA fusion gene	None	Imatinib mesylate	Remission
Koneru et al^Citation18	2013	83, female	HES Loeffler’s endocarditis, LV thrombus	Endocarditis	Corticosteroids, anticoagulants, and immunosuppressants	Good response
Marina et al^Citation19	2013	83, female	HES	None	Infliximab	Resolved
Fathi et al^Citation26	2014	27, female	HES and CEL	None	Glucocorticoids, vincristine, cytarabine	Responded to cytarabine
Herndon et al^Citation27	2020	27, female	HES	Cholangitis	Vedolizumab	Worsened
Described case	2022	24, male	HES, APS	Cholangitis	Steroids, immunosuppressants, colectomy	Respond to colectomy

Abbreviations: APS, antiphospholipid syndrome; CEL, chronic eosinophilic leukemia; HES, hyper-eosinophilic syndrome; LV, left ventricle; PDGFRA, FIP1L1-platelet-derived growth factor receptor alpha.

Table 2 Summary of Case Reports and Case Series in Literature of UC and ITP

Author	Year	No. of Cases	Clinical Characteristics	Treatments Received	ITP Outcome
Zlatanic et al^Citation29	1997	19 cases	UC preceded the onset of ITP by days or years	Immunosuppressive agents	Resolved
Mizuta et al^Citation32	2003	17 cases	Age at onset 17–60 years 64.7% males Duration between UC and ITP was up to 7 years	Steroids, immunosuppressants, splenectomy, colectomy	15 cases: medical treatment 3 Cases: splenectomy 1 case: colectomy 1 case died with ICH
Chandra et al^Citation33	2014	40 cases	Age: 5–65 years 60% males	Steroids, 5-ASA, azathioprine, anti-D antibodies, infliximab, cyclosporine, IVIG, metronidazole, 9-MP, splenectomy, colectomy	17 responded to medical therapy 13 underwent splenectomy 10 underwent colectomy.
Papadatou et al^Citation39	2014	1 case	14 years, boy	Steroids, IVIG, colectomy	Responded only to colectomy
Dehal et al^Citation38	2014	1 case	19 years, female, recurrent DVT	Steroids, colectomy, splenectomy	Responded to surgery
Casella et al^Citation14	2016	1 case	37 years, male	Steroids	Resolved
Gomez et al^Citation35	2016	1 case	34 years, female, ITP after infliximab	Stopping infliximab	Resolved
Queliza^Citation23	2017	1 case	14 years, male	Infliximab and mesalamine	Resolved
Komeda et al^Citation31	2020	1 case	24 years, male	Steroids, cyclosporine, tofacitinib.	Responded only to tofacitinib
Chan et al^Citation34	2020	1 case	66 years, male, Evan syndrome	Steroids and IVIG	Resolved
Guarina et al^Citation37	2021	8 cases	Pediatric age, 37.5% males	Steroids, IVIG, MMF, sirolimus, eltrombopag, colectomy	6 responded to medical therapy 2 cases: colectomy
The described case	2022	1 case	35 years, female	Steroids, azathioprine, rituximab, romiplostim, anti-TNF therapy, thrombopoietin receptor agonists, vedolizumab, colectomy	Responded only to colectomy

Abbreviations: 5-ASA, 5-aminosalicylic acid; 6-MP, 6 mercaptopurine; CEL, chronic eosinophilic leukemia; DVT, Deep venous thrombosis; HES, hyper-eosinophilic syndrome; ICH, Intracranial hemorrhage; IVIG, intravenous immunoglobulin; LV, Left ventricle; MMF, mycophenolate mofetil; PDGFRA, FIP1L1-platelet-derived growth factor receptor alpha.

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