Allergy Asthma Respir Dis.  2015 Jan;3(1):77-81. 10.4168/aard.2015.3.1.77.

Idiopathic hypereosinophilic syndrome presenting with urinary frequency, abdominal pain, and diarrhea

• Kim JK
• Kim JH
• Park HM
• Jeong YS
• Choi CJ
• Na SK
• Kim JH
• Song YR
• Hwang YI
• Jang SH
• Jung KS

• KMID: 2262283
• DOI: http://doi.org/10.4168/aard.2015.3.1.77

Abstract

Idiopathic hypereosinophilic syndrome (IHES) is a rare disorder defined by persistent blood eosinophilia, evidence of eosinophil-associated organ dysfunction and absence of secondary causes. Eosinophilic infiltration and its mediator release can cause damage to multiple organs. Although IHES can involve every organ system, bladder involvement is rarely evidenced. We recently reported a case of IHES with both bladder and gastrointestinal tract involvement. A 43-year-old woman visited Hallym University Sacred Heart Hospital complaining of urinary frequency, abdominal pain, and diarrhea for several months. Abdominal pelvic computed tomographic scan showed diffuse wall thickenings in her bladder and colon with small pelvic ascites. Laboratory investigation showed a marked peripheral eosinophilia and tissue biopsies confirmed eosinophilic infiltration in the bladder wall, esophagus, and duodenum. The patient was treated with prednisolone and her eosinophilia and symptoms have gradually improved.

Keyword

Hypereosinophilic syndrome; Eosinophilic esophagitis; Enteritis; Cystitis

MeSH Terms

Abdominal Pain*
Adult
Ascites
Biopsy
Colon
Cystitis
Diarrhea*
Duodenum
Enteritis
Eosinophilia
Eosinophilic Esophagitis
Eosinophils
Esophagus
Female
Gastrointestinal Tract
Heart
Humans
Hypereosinophilic Syndrome*
Prednisolone
Urinary Bladder
Prednisolone

Figure

• 

  Fig. 1 (A) There is diffuse wall thickening of urinary bladder on the abdominal-pelvic computed tomography (axial view). (B) Cystoscopic examination finding shows edematous wall of bladder.

• 

  Fig. 2 (A) Bladder biopsy shows eosinophilic infiltration (H&E, ×200). (B) Esophageal biopsy presents chronic esophagitis with eosinophilic infiltration (H&E, ×400). (C) Duodenal biopsy of chronic inflammation with a few eosinophils (H&E, ×400).

• 

  Fig. 3 Treatment and prognosis. A full line means the eosinophil counts of blood. HD, hospital day; PD, prednisolone.

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