J Rheum Dis.  2017 Jun;24(3):165-168. 10.4078/jrd.2017.24.3.165.

Hypereosinophilic Syndrome Associated with the Onset of Rheumatoid Arthritis: A Case Report

• Park JH
• Lee WS
• Park SJ
• Yoo WH

• KMID: 2385345
• DOI: http://doi.org/10.4078/jrd.2017.24.3.165

Abstract

Idiopathic hypereosinophilic syndrome (HES) is a disorder characterized by the sustained overproduction of eosinophils and multiple organ damage. Rheumatologic manifestations of HES are infrequent, but persistent eosinophilia is observed in approximately 10% to 40% of patients with rheumatoid arthritis (RA). This finding may be a result of the RA itself and is often associated with active disease and the presence of extra-articular features. We describe the case of a 48-year-old man affected by HES who subsequently developed RA. Both HES and RA responded rapidly to the corticosteroid and methotrexate therapy. In this patient, the initiation of RA and HES was related, suggesting a common pathogenetic link between these two diseases.

Keyword

Hypereosinophilic syndrome; Rheumatoid arthritis

MeSH Terms

Arthritis, Rheumatoid*
Eosinophilia
Eosinophils
Humans
Hypereosinophilic Syndrome*
Methotrexate
Middle Aged
Methotrexate

Figure

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  Figure 1. High-resolution computed tomography scan of the lungs reveals subpleural distribution of small hyperdense nodules (black arrow) in the right lower lobe.

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  Figure 2. Bone scan shows hot spots in both ankles and wrists, a sign of arthritis. Delayed regional bone images show increased radiotracer uptake in both ankles, both feet, and both wrists.

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