A Case of Idiopathic Hypereosinophilic Syndrome Presenting With Acute Respiratory Distress Syndrome

Abstract

Although idiopathic hypereosinophilic syndrome(IHES) commonly involves the lung, it is rarely associated with acute respiratory distress syndrome (ARDS). Here we describe a case of IHES presented in conjunction with ARDS. A 37-year-old male visited the emergency department at Samsung Medical Center, Seoul, Korea, with a chief complaint of dyspnea. Blood tests showed profound peripheral eosinophilia and thrombocytopenia. Patchy areas of consolidation with ground-glass opacity were noticed in both lower lung zones on chest radiography. Rapid progression of dyspnea and hypoxia despite supplement of oxygen necessitated the use of mechanical ventilation. Eosinophilic airway inflammation was subsequently confirmed by bronchoalveolar lavage, leading to a diagnosis of IHES. High-dose corticosteroids were administered, resulting in a dramatic clinical response.

A novel treatment workflow of idiopathic hypereosinophilic syndrome: a single-center retrospective cohort study

“…In a multicenter study, 85% of HES patients who received corticosteroid monotherapy experienced complete or partial response after 1 month of treatment [6] . However, it has been reported in more recent studies that patients with IHES may respond to hormone therapy more quickly [7] . Our results indicate that if hormone therapy fails to elicit a response within 10 days, second-line drugs, such as antineoplastic/immunosuppressive agents, should be considered.…”

Hyperleucocytosis as an unusual presentation of hypereosinophilic pneumonitis with acute respiratory distress syndrome

“…Less commonly, it may be primary, implying neoplastic or clonal disorder. 6 Although lung involvement is relatively common, occurring in approximately 40% of IHES patients, 7 associated ARDS is rare, with only a few cases described in the literature to date. Since HES is a reversible etiology of ARDS, the presence of eosinophilia in ARDS should never be ignored.…”

Chronic eosinophilic leukemia with aFIP1L1-PDGFRArearrangement: Two case reports and a review of Korean cases

“…In a Korean study [ 4 ], only 1 case with a PDGFRA rearrangement was detected among 34 hypereosinophilia patients who were suspected of having clonal eosinophilia. Until now, few cases of PDGFRA , PDGFRB , or FGFR1 rearrangements have been reported in Korea [ 4 , 5 , 6 , 7 , 8 , 9 ], and these are summarized in Table 1 .…”