Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
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Case Report

Volume 8, Number 11, November 2017, pages 335-339

A 37-Year-Old Female With Abdominal Pain and Diarrhea: A Case of Idiopathic Hypereosinophilic Syndrome


Figure 1.
Figure 1. Abdominal CT, thickening of distal esophagus (white arrow) is evident. A left-sided pleural effusion is also seen (yellow arrow head).
Figure 2.
Figure 2. Abdominal CT, small bowel thickening (arrow) is evident in both axial (right) and coronal images.
Figure 3.
Figure 3. Hematoxylin and eosin stains of proximal (right) and distal (left) esophagus. Abundant eosinophils present (arrow), with the formation of eosinophilic abscess.
Figure 4.
Figure 4. Hematoxylin and eosin stain of duodenal mucosa. Eosinophilic duodenitis with diffuse lamina propria eosinophils (arrow).


Table 1. Etiology of Eosinophilia
Modified from [2, 5].
InfectiousViral (HIV, HTLV1, EBV)
Parasitic (Strongyloides spp, Sarcocystis hominis, Isospora belli, Schistosoma spp., filariasis)
Fungal (Coccidioides spp)
Bacterial (tuberculosis)
Atopic dermatitis
Allergic rhinitis
MalignanciesSolid tumors
Systemic mastocytosis
Hematologic malignancies (Hodgkin lymphoma, chronic eosinophilic leukemia, chronic myeloid leukemia)
MedicationsAnticonvulsivants (carbamazepine, valproic acid)
Antidepressives (IRSS, amitriptyline)
Antibiotics (beta-lactam antibiotics, trimethoprim-sulfamethoxazole, quinolones)
Antiretrovirals (efavirenz, abacavir)
Hypereosinophilic syndrome (HES)Myeloid HES
Lymphocytic HES
Idiopathic HES
Associated HES
Overlap HES
Familiar HES
Immune deregulationAllergic bronchopulmonar Aspergiliosis
HyperIgE syndrome (Job syndrome)
Eosinophilic granulomatosis with polyangiitis
Gleich syndrome
IgG4 disease
Inflammatory bowel disease
OthersAdrenal insufficiency
Radiation exposure
Cholesterol emboli