{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:39:24Z","timestamp":1762508364474,"version":"3.37.3"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,1,23]],"date-time":"2021-01-23T00:00:00Z","timestamp":1611360000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,23]],"date-time":"2021-01-23T00:00:00Z","timestamp":1611360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pediatr"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Peripheral blood eosinophilia is identified in numerous medical conditions associated with allergic, infectious, and inflammatory processes mostly as reactive eosinophilia with or without tissue eosinophilia. In hospitalized neonates, eosinophilia is common with an inverse relationship with gestational age and occurs solely as mild eosinophilia in the majority of cases. In the literature, eosinophilia has been proposed as a possible risk factor for venous thromboembolism. However, few reports are found on thromboembolic events including portal vein thrombosis (PVT) associated with eosinophilia in the newborn period.<\/jats:p>\n                <jats:p>Neonates, particularly preterm infants, are vulnerable to thrombosis due to the immature and developing hemostatic system with little reserve capacity, which occurs as catheter-related thrombosis in most cases.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A male newborn at 34<jats:sup>+\u20095<\/jats:sup> weeks\u2019 gestation presented with a left portal venous thrombus and hematochezia after initial cow\u2019s milk feeding in the setting of blood hypereosinophilia for a prolonged period of time without central venous catheterization. The infant was diagnosed with PVT and food protein-induced allergic proctocolitis (FPIAP) and showed complete resolution of the conditions with expectant management with food avoidance, including the normalized eosinophil count.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Our experience suggests that in the setting of hypereosinophilia with a prolonged duration in premature neonates, FPIAP should be suspected in case of hematochezia in otherwise healthy infants, and considering the increased thrombotic risk by the hypereosinophilia and premature newborn status, evaluation for neonatal thrombosis may be needed, including PVT with the potential risk for the more serious, but uncommon, late complications encompassing portal hypertension.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12887-021-02510-9","type":"journal-article","created":{"date-parts":[[2021,1,23]],"date-time":"2021-01-23T05:03:33Z","timestamp":1611378213000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Portal vein thrombosis and food protein-induced allergic proctocolitis in a premature newborn with hypereosinophilia: a case report"],"prefix":"10.1186","volume":"21","author":[{"given":"Cheong-Jun","family":"Moon","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tae Hee","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5219-8384","authenticated-orcid":false,"given":"Hyun-Seung","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,1,23]]},"reference":[{"key":"2510_CR1","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1016\/S0095-5108(05)70041-5","volume":"27","author":"SE Sullivan","year":"2000","unstructured":"Sullivan SE, Calhoun DA. Eosinophilia in the neonatal intensive care unit. Clin Perinatol. 2000;27:603\u201322.","journal-title":"Clin Perinatol"},{"key":"2510_CR2","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1038\/sj.jp.7211226","volume":"25","author":"SE Juul","year":"2005","unstructured":"Juul SE, Haynes JW, McPherson RJ. Evaluation of eosinophilia in hospitalized preterm infants. J Perinatol. 2005;25:182\u20138.","journal-title":"J Perinatol"},{"key":"2510_CR3","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/S1875-9572(10)60021-6","volume":"51","author":"JM Yen","year":"2010","unstructured":"Yen JM, Lin CH, Yang MM, Hou ST, Lin AH, Lin YJ. Eosinophilia in very low birth weight infants. Pediatr Neonatol. 2010;51:116\u201323.","journal-title":"Pediatr Neonatol"},{"key":"2510_CR4","doi-asserted-by":"publisher","first-page":"1592","DOI":"10.1056\/NEJM199805283382206","volume":"338","author":"ME Rothenberg","year":"1998","unstructured":"Rothenberg ME. Eosinophilia. N Engl J Med. 1998;338:1592\u2013600.","journal-title":"N Engl J Med"},{"key":"2510_CR5","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1016\/j.blre.2009.01.001","volume":"23","author":"P Valent","year":"2009","unstructured":"Valent P. Pathogenesis, classification, and therapy of eosinophilia and eosinophil disorders. Blood Rev. 2009;23:157\u201365.","journal-title":"Blood Rev"},{"key":"2510_CR6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.mcna.2019.08.005","volume":"104","author":"FL Kuang","year":"2020","unstructured":"Kuang FL. Approach to patients with eosinophilia. Med Clin North Am. 2020;104:1\u201314.","journal-title":"Med Clin North Am"},{"key":"2510_CR7","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1111\/ijlh.12955","volume":"41","author":"RL Larsen","year":"2019","unstructured":"Larsen RL, Savage NM. How I investigate eosinophilia. Int J Lab Hematol. 2019;41:153\u201361.","journal-title":"Int J Lab Hematol"},{"key":"2510_CR8","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1159\/000431305","volume":"108","author":"LS Wahidi","year":"2015","unstructured":"Wahidi LS, Sherman J, Miller MM, Zaghouani H, Sherman MP. Early persistent blood eosinophilia in necrotizing enterocolitis is a predictor of late complications. Neonatology. 2015;108:137\u201342.","journal-title":"Neonatology"},{"key":"2510_CR9","first-page":"161","volume":"8","author":"M Calbi","year":"1998","unstructured":"Calbi M, Giacchetti L. Low breast milk IgA and high blood eosinophil count in breast-fed newborns determine higher risk for developing atopic eczema after an 18-month follow-up. J Investig Allergol Clin Immunol. 1998;8:161\u20134.","journal-title":"J Investig Allergol Clin Immunol"},{"key":"2510_CR10","doi-asserted-by":"publisher","first-page":"8359","DOI":"10.1038\/s41598-020-65128-4","volume":"10","author":"Y Liu","year":"2020","unstructured":"Liu Y, Meng X, Feng J, Zhou X, Zhu H. Hypereosinophilia with concurrent venous thromboembolism: clinical features, potential risk factors, and short-term outcomes in a Chinese cohort. Sci Rep. 2020;10:8359.","journal-title":"Sci Rep"},{"key":"2510_CR11","doi-asserted-by":"publisher","first-page":"670","DOI":"10.2174\/157016112801784594","volume":"10","author":"A Maino","year":"2012","unstructured":"Maino A, Rossio R, Cugno M, Marzano AV, Tedeschi A. Hypereosinophilic syndrome, Churg-Strauss syndrome and parasitic diseases: possible links between eosinophilia and thrombosis. Curr Vasc Pharmacol. 2012;10:670\u20135.","journal-title":"Curr Vasc Pharmacol"},{"key":"2510_CR12","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1177\/1076029609348314","volume":"17","author":"PR Ames","year":"2011","unstructured":"Ames PR, Aloj G, Gentile F. Eosinophilia and thrombosis in parasitic diseases: an overview. Clin Appl Thromb Hemost. 2011;17:33\u20138.","journal-title":"Clin Appl Thromb Hemost"},{"key":"2510_CR13","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1177\/1076029609343450","volume":"17","author":"PR Ames","year":"2011","unstructured":"Ames PR. Recurrent abdominal thrombosis despite heparin thromboprophylaxis in a patient with transient eosinophilia. Clin Appl Thromb Hemost. 2011;17:229\u201331.","journal-title":"Clin Appl Thromb Hemost"},{"key":"2510_CR14","doi-asserted-by":"publisher","first-page":"2139","DOI":"10.2169\/internalmedicine.53.2567","volume":"53","author":"H Sano","year":"2014","unstructured":"Sano H, Fukuoka T, Maruyama H, Hayashi T, Tanahashi N. Cerebral sinovenous thrombosis in a patient with transient eosinophilia. Intern Med. 2014;53:2139\u201342.","journal-title":"Intern Med"},{"key":"2510_CR15","doi-asserted-by":"publisher","first-page":"S33","DOI":"10.1016\/S0049-3848(19)30364-0","volume":"181","author":"G Kenet","year":"2019","unstructured":"Kenet G, Cohen O, Bajorat T, Nowak-G\u00f6ttl U. Insights into neonatal thrombosis. Thromb Res. 2019;181:S33\u20136.","journal-title":"Thromb Res"},{"key":"2510_CR16","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1136\/archdischild-2018-316762","volume":"105","author":"GH Dubbink-Verheij","year":"2020","unstructured":"Dubbink-Verheij GH, Visser R, Roest AA, van Ommen CH, Te Pas AB, Lopriore E. Thrombosis after umbilical venous catheterisation: prospective study with serial ultrasound. Arch Dis Child Fetal Neonatal Ed. 2020;105:299\u2013303.","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"2510_CR17","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1016\/j.jpeds.2006.01.051","volume":"148","author":"I Morag","year":"2006","unstructured":"Morag I, Epelman M, Daneman A, Moineddin R, Parvez B, Shechter T, et al. Portal vein thrombosis in the neonate: risk factors, course, and outcome. J Pediatr. 2006;148:735\u20139.","journal-title":"J Pediatr"},{"key":"2510_CR18","doi-asserted-by":"publisher","first-page":"e11","DOI":"10.2500\/aap.2020.41.190017","volume":"41","author":"PG Cetinkaya","year":"2020","unstructured":"Cetinkaya PG, Kahveci M, Karaatmaca B, Esenboga S, Sahiner UM, Sekerel BE, et al. Predictors for late tolerance development in food protein-induced allergic proctocolitis. Allergy Asthma Proc. 2020;41:e11\u20138.","journal-title":"Allergy Asthma Proc"},{"key":"2510_CR19","doi-asserted-by":"publisher","first-page":"1692","DOI":"10.1016\/j.jaip.2019.12.029","volume":"8","author":"VM Martin","year":"2020","unstructured":"Martin VM, Virkud YV, Seay H, Hickey A, Ndahayo R, Rosow R, et al. Prospective assessment of pediatrician-diagnosed food protein-induced allergic proctocolitis by gross or occult blood. J Allergy Clin Immunol Pract. 2020;8:1692\u20139.e1.","journal-title":"J Allergy Clin Immunol Pract"},{"key":"2510_CR20","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1016\/j.siny.2011.08.005","volume":"16","author":"S Williams","year":"2011","unstructured":"Williams S, Chan AK. Neonatal portal vein thrombosis: diagnosis and management. Semin Fetal Neonatal Med. 2011;16:329\u201339.","journal-title":"Semin Fetal Neonatal Med"},{"key":"2510_CR21","doi-asserted-by":"publisher","first-page":"1359","DOI":"10.1038\/s41372-018-0132-9","volume":"38","author":"M Cabannes","year":"2018","unstructured":"Cabannes M, Bouissou A, Favrais G, Semb\u00e9ly-Taveau C, Morales L, Favreau A, et al. Systematic ultrasound examinations in neonates admitted to NICU: evolution of portal vein thrombosis. J Perinatol. 2018;38:1359\u201364.","journal-title":"J Perinatol"},{"key":"2510_CR22","doi-asserted-by":"publisher","first-page":"e27572","DOI":"10.1002\/pbc.27572","volume":"66","author":"MD Bhatt","year":"2019","unstructured":"Bhatt MD, Patel V, Butt ML, Chan AKC, Paes B. Thrombosis and hemostasis in newborns (THiN) group. Outcomes following neonatal portal vein thrombosis: a descriptive, single-center study and review of anticoagulant therapy. Pediatr Blood Cancer. 2019;66:e27572.","journal-title":"Pediatr Blood Cancer"},{"key":"2510_CR23","doi-asserted-by":"publisher","first-page":"249784","DOI":"10.1155\/2014\/249784","volume":"2014","author":"J Jo","year":"2014","unstructured":"Jo J, Garssen J, Knippels L, Sandalova E. Role of cellular immunity in cow's milk allergy: pathogenesis, tolerance induction, and beyond. Mediat Inflamm. 2014;2014:249784.","journal-title":"Mediat Inflamm"},{"key":"2510_CR24","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1111\/j.1398-9995.1991.tb00538.x","volume":"46","author":"K Fredens","year":"1991","unstructured":"Fredens K, Dahl R, Venge P. In vitro studies of the interaction between heparin and eosinophil cationic protein. Allergy. 1991;46:27\u20139.","journal-title":"Allergy"},{"key":"2510_CR25","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1055\/s-0038-1645072","volume":"63","author":"B Rucinski","year":"1990","unstructured":"Rucinski B, Niewiarowski S, Strzyzewski M, Holt JC, Mayo KH. Human platelet factor 4 and its C-terminal peptides: heparin binding and clearance from the circulation. Thromb Haemost. 1990;63:493\u20138.","journal-title":"Thromb Haemost"},{"key":"2510_CR26","doi-asserted-by":"publisher","first-page":"1721","DOI":"10.1172\/JCI116382","volume":"91","author":"A Slungaard","year":"1993","unstructured":"Slungaard A, Vercellotti GM, Tran T, Gleich GJ, Key NS. Eosinophil cationic granule proteins impair thrombomodulin function. A potential mechanism for thromboembolism in hypereosinophilic heart disease. J Clin Invest. 1993;91:1721\u201330.","journal-title":"J Clin Invest"},{"key":"2510_CR27","doi-asserted-by":"publisher","first-page":"892","DOI":"10.1111\/j.1365-2141.1995.tb05211.x","volume":"90","author":"HY Mukai","year":"1995","unstructured":"Mukai HY, Ninomiya H, Ohtani K, Nagasawa T, Abe T. Major basic protein binding to thrombomodulin potentially contributes to the thrombosis in patients with eosinophilia. Br J Haematol. 1995;90:892\u20139.","journal-title":"Br J Haematol"},{"key":"2510_CR28","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.1172\/JCI115416","volume":"88","author":"M Levi","year":"1991","unstructured":"Levi M, Hack CE, de Boer JP, Brandjes DP, B\u00fcller HR, ten Cate JW. Reduction of contact activation related fibrinolytic activity in factor XII deficient patients. Further evidence for the role of the contact system in fibrinolysis in vivo. J Clin Invest. 1991;88:1155\u201360.","journal-title":"J Clin Invest"},{"key":"2510_CR29","doi-asserted-by":"publisher","first-page":"1200","DOI":"10.1007\/BF02536531","volume":"26","author":"A Ojima-Uchiyama","year":"1991","unstructured":"Ojima-Uchiyama A, Masuzawa Y, Sugiura T, Waku K, Fukuda T, Makino S. Production of platelet-activating factor by human normodense and hypodense eosinophils. Lipids. 1991;26:1200\u20133.","journal-title":"Lipids."},{"key":"2510_CR30","doi-asserted-by":"publisher","first-page":"1271","DOI":"10.1084\/jem.172.4.1271","volume":"172","author":"MS Rohrbach","year":"1990","unstructured":"Rohrbach MS, Wheatley CL, Slifman NR, Gleich GJ. Activation of platelets by eosinophil granule proteins. J Exp Med. 1990;172:1271\u20134.","journal-title":"J Exp Med"},{"key":"2510_CR31","doi-asserted-by":"publisher","first-page":"995","DOI":"10.1182\/blood-2006-02-004945","volume":"109","author":"C Moosbauer","year":"2007","unstructured":"Moosbauer C, Morgenstern E, Cuvelier SL, Manukyan D, Bidzhekov K, Albrecht S, et al. Eosinophils are a major intravascular location for tissue factor storage and exposure. Blood. 2007;109:995\u20131002.","journal-title":"Blood"},{"key":"2510_CR32","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1007\/s11739-007-0076-0","volume":"2","author":"F Santilli","year":"2007","unstructured":"Santilli F, Basili S, Ferroni P, Dav\u00ec G. CD40\/CD40L system and vascular disease. Intern Emerg Med. 2007;2:256\u201368.","journal-title":"Intern Emerg Med"},{"key":"2510_CR33","first-page":"CS53","volume":"12","author":"J Monterrubio Villar","year":"2006","unstructured":"Monterrubio Villar J, C\u00f3rdoba L\u00f3pez A, Macayo S\u00e1nchez AJ. Idiopathic eosinophilia associated with portal vein and massive thrombosis: successful thrombolysis with streptokinase. Med Sci Monit. 2006;12:CS53\u20136.","journal-title":"Med Sci Monit"},{"key":"2510_CR34","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1159\/000081274","volume":"112","author":"M Mates","year":"2004","unstructured":"Mates M, Nesher G, Roth B, Rosenberg R, Heyd J, Hershko C. Transient severe eosinophilia precipitating massive venous thrombosis in a patient with hereditary thrombophilia. Acta Haematol. 2004;112:209\u201311.","journal-title":"Acta Haematol"},{"key":"2510_CR35","doi-asserted-by":"publisher","first-page":"382","DOI":"10.4070\/kcj.2009.39.9.382","volume":"39","author":"HS An","year":"2009","unstructured":"An HS, Baek JS, Kwon BS, Kim GB, Bae EJ, Noh CI, et al. A case of pulmonary thromboembolism associated with hypereosinophilia in a child. Korean Circ J. 2009;39:382\u20135.","journal-title":"Korean Circ J"},{"key":"2510_CR36","doi-asserted-by":"publisher","first-page":"136","DOI":"10.3389\/fped.2017.00136","volume":"5","author":"KM Haley","year":"2017","unstructured":"Haley KM. Neonatal venous thromboembolism. Front Pediatr. 2017;5:136.","journal-title":"Front Pediatr"},{"key":"2510_CR37","doi-asserted-by":"crossref","unstructured":"Makatsariya A, Bitsadze V, Khizroeva J, Vorobev A, Makatsariya N, Egorova E, et al. Neonatal thrombosis. J Matern Fetal Neonatal Med. 2020:1\u20139.","DOI":"10.1080\/14767058.2020.1743668"}],"container-title":["BMC Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12887-021-02510-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12887-021-02510-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12887-021-02510-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,23]],"date-time":"2021-01-23T05:03:47Z","timestamp":1611378227000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpediatr.biomedcentral.com\/articles\/10.1186\/s12887-021-02510-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,23]]},"references-count":37,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["2510"],"URL":"https:\/\/doi.org\/10.1186\/s12887-021-02510-9","relation":{},"ISSN":["1471-2431"],"issn-type":[{"type":"electronic","value":"1471-2431"}],"subject":[],"published":{"date-parts":[[2021,1,23]]},"assertion":[{"value":"23 September 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 January 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 January 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The present study was approved by the Institutional Review Board (IRB) of CHA Gangnam Medical Center (IRB No. GCI 2020\u201305-009). The patient\u2019s legal guardian provided written informed consent for publication of this case report and accompanying images.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient\u2019s mother for publication of this case report and accompanying images. The mother gave us full permission for the materials to appear in the print and online, and grant permission to third parties to reproduce this material.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"49"}}