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British Journal of Anaesthesia, 1992, Vol. 69, No. 6 653-656
© 1992 The Board of Management and Trustees of the British Journal of Anaesthesia


case-report

GENERAL ANAESTHESIA AND THE HYPEREOSINOPHILIC SYNDROME: SEVERE POSTOPERATIVE COMPLICATIONS IN TWO PATIENTS

G. SAMSOON, F.R.C.ANAES.1, A. B. KNIGHT-GEORGE, F.R.C.ANAES.1,*,1, R. P. BRITT, F.R.C.PATH.2 and M. E. WOOD, M.R.C.P.2,{dagger}

1Department of Anaesthesia, Hillingdon Hospital Pield Heath Road, Uxbridge, Middlesex UB8 3NN
2Department of Haematology, Hillingdon Hospital Pield Heath Road, Uxbridge, Middlesex UB8 3NN

1Correspondence to A. B.K.-G.

Two patients with markedly increased eosinophil counts developed severe postoperative complications after general anaesthesia. One patient suffered life-threatening Adult Respiratory Distress Syndrome (ARDS), while the other presented with a coagulopathy and less severe respiratory problems. The hypereosinophilic syndrome is described and the possibility of a role of eosinophils in the pathogenesis of tissue injury is discussed. These cases suggest that, in patients with marked eosinophilia requiring general anaesthesia, perloperative steroid cover is advisable. This may reduce or prevent serious lung damage and other complications.

*Present addresses: Department of Anaesthesia, The Hammersmith Hospital, DuCane Road, London W12 0HS.

{dagger}Department of Haematology, The Royal Free Hospital, Pond Street, London NW3 2QG.


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