Anemia ; complications ; Child ; Female ; Fever ; complications ; Humans ; Hypereosinophilic Syndrome ; complications ; diagnosis ; therapy ; Splenomegaly ; complications

Anemia ; etiology ; Erythema ; etiology ; Fatal Outcome ; Female ; Fever ; etiology ; Humans ; Hypereosinophilic Syndrome ; complications ; diagnosis ; Infant

Adult ; Humans ; Hypereosinophilic Syndrome ; complications ; drug therapy ; Lymphatic Diseases ; diagnosis ; etiology ; pathology ; Male ; Treatment Outcome

Idiopathic hypereosinophilic syndrome is defined as the presence of prolonged eosinophilia without an identifiable underlying cause and with evidence of end-organ dysfunction. The organs involved are the heart, bone marrow, nervous system, lungs, liver, skin, and gastrointestinal tract. Hepatic involvement is found in about 30% of patients of idiopathic hypereosinophilic syndrome. It occurs rarely in infants and children. In this report, we experienced one case of idiopathic hypereosinophilic syndrome with hepatic involvement in a 5-year-old boy who complained of intermittent fever and right upper quadrant abdominal pain. An abdominal ultrasound examination revealed an ill-defined low-echoic lesion in the liver. Pathologic findings of a biopsy specimen clearly showed the infiltration of eosinophils in the liver. Laboratory data disclosed absolute eosinophilia. There was no evidence of allergic disease or parasitic infestation.
Child, Preschool ; English Abstract ; Eosinophils/pathology ; Human ; Hypereosinophilic Syndrome/*complications/diagnosis ; Liver/pathology ; Liver Diseases/*complications/diagnosis/pathology ; Male

Hypereosinophilic syndrome (HES) is a clinical disorder characterized by persistent eosinophilia and systemic involvement, in which a specific causative factor for the eosinophilia cannot be verified during a certain period of time. There have been only a few reported cases of this syndrome associated with malignant lymphoma. We report a case of peripheral T-cell lymphoma-unspecified with hypereosinophilic syndrome. The patient was a 42-year-old woman with an uncontrolled fever and a sore throat. Eosinophilia was observed on the peripheral blood smear. We confirmed the diagnosis by bone marrow and liver biopsies: A bone marrow aspiration demonstrated markedly increased eosinophils (24.8%), and a liver biopsy demonstrated infiltration by scattered eosinophils and atypical lymphoid cells, which were confirmed to be T-cell lymphoma cells. This case was a distinctive presentation of peripheral T-cell lymphoma with hypereosinophilic syndrome, probably due to a paraneoplastic condition.
Recurrence ; Pleural Effusion/*etiology ; Lymphoma, T-Cell, Peripheral/complications/*diagnosis ; Liver Neoplasms/complications/*diagnosis ; Hypereosinophilic Syndrome/*etiology ; Humans ; Female ; Fatal Outcome ; Adult

We report here a case with hypereosinophilia and peripheral artery occlusion. A 32-yr-old Korean woman presented to us with lower extremity swelling and pain. Angiography revealed that multiple lower extremity arteries were occlusive. The biopsy specimen showed perivascular and periadnexal dense eosinophilic infiltration in dermis and subcutaneous adipose tissue. Laboratory investigations revealed a persistent hypereosinophilia. She was prescribed prednisolone 60 mg daily. Her skin lesion and pain were improved and the eosinophil count was dramatically decreased. After discharge, eosinophil count gradually increased again. Cyanosis and pain of her fingers recurred. She had been treated with cyclophosphamide pulse therapy. Her eosinophilia was decreased, but the cyanosis and tingling sense were progressive. The extremity arterial stenoses were slightly progressed. Skin biopsy showed perivascular eosinophilic infiltration in the dermis and CD40 ligand (CD40L) positive eosinophilic infiltration. The serum TNF-alpha was markedly increased. These results suggest that CD40L (a member of TNF-alpha superfamily) could play a role in the inflammatory processes when eosinophil infiltration and activation are observed. We prescribed prednisolone, cyclophosphamide, clopidogrel, cilostazol, beraprost and nifedipine, and she was discharged.
Adult ; Arterial Occlusive Diseases/*diagnosis/etiology ; CD40 Ligand/analysis ; Cyanosis/etiology ; Diagnosis, Differential ; Eosinophilia/*diagnosis/etiology ; Female ; Gangrene/etiology ; Humans ; Hypereosinophilic Syndrome/blood/complications/*diagnosis ; Immunohistochemistry ; Peripheral Vascular Diseases/*diagnosis/etiology ; Skin/chemistry/pathology ; Tumor Necrosis Factor-alpha/metabolism ; Vasculitis/*diagnosis/etiology