title: Multiple cerebral infarctions in a young patient with heroin-induced hypereosinophilic syndrome.
abstract: Hypereosinophilic syndrome represents a rare cause for cerebral infarctions and inflammatory neurological disorders. Various possible pathogenic mechanisms for cerebral infarctions have already been discussed. Complex mechanisms including a local hypercoagulability by eosinophilic granules as well as a direct damage to endothelial cells, leading to alterations of the microcirculation seem to be involved. The changing pattern of heroin use to inhalation/sniffing leading to an increasing abuse may cause a rise in the prevalence of Heroin induced eosinophilia, as it has been reported in a case of eosinophilic pneumonia associated with heroin inhalation. To our knowledge, the present case report displays the first description of stroke in the setting of heroin induced hypereosinophilia. Thus, besides usual vasoconstriction, HES should be considered in drug-induced cerebral infarctions.
authors.affiliation: Department of Neurology, St Josef-Hospital, Medical Faculty, Ruhr University Bochum, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Bolz
authors.affiliation: Department of Neurology, St Josef-Hospital, Medical Faculty, Ruhr University Bochum, Germany.
authors.forename: Saskia H
authors.initials: SH
authors.lastname: Meves
authors.affiliation: Department of Cardiology, St Josef-Hospital, Medical Faculty, Ruhr University Bochum, Germany.
authors.forename: Kaffer
authors.initials: K
authors.lastname: Kara
authors.affiliation: Department of Hematology/Oncology, St Josef-Hospital, Medical Faculty, Ruhr University Bochum, Germany.
authors.forename: Anke
authors.initials: A
authors.lastname: Reinacher-Schick
authors.affiliation: Department of Neurology, St Josef-Hospital, Medical Faculty, Ruhr University Bochum, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Gold
authors.affiliation: Department of Neurology, St Josef-Hospital, Medical Faculty, Ruhr University Bochum, Germany. Electronic address: christos.krogias@rub.de.
authors.forename: Christos
authors.initials: C
authors.lastname: Krogias
mesh_terms: D000328:Adult; D002544:Cerebral Infarction / Q000175:diagnosis / Q000209:etiology*; D003932:Heroin / Q000009:adverse effects*; D006801:Humans; D017681:Hypereosinophilic Syndrome / Q000139:chemically induced* / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male
chemical_list: D003932:Heroin
keywords: Cerebrovascular disease; Heroin; Hypereosinophilic Syndrome; MRI; Stroke