Eosinophilic Pleural Effusion: A Rare Manifestation of Hypereosinophilic Syndrome

Abstract

Several causes of eosinophilic pleural effusions have been described with malignancy being the commonest cause. Hypereosinophilic syndrome (HES) is a rare disease and very few cases have been reported of HES presenting as eosinophilic pleural effusion (EPE). We report a case of a 26-year-old male who presented with shortness of breath. He had bilateral pleural effusions, generalized lymphadenopathy, splenomegaly, and leukocytosis with marked peripheral blood eosinophilia. The pleural fluid was exudative, with 25%–30% eosinophilis, and absence of neoplastic cells. Hypereosinophilic syndrome was diagnosed after other causes of eosinophilia were excluded. He continued to be dyspneic with persistent accumulation of eosinophilic pleural fluid, even after his peripheral eosinophil count had normalized in response to treatment. This patient represents a very unusual presentation of HES with dyspnea and pleural effusions and demonstrates that treatment based on response of peripheral eosinophil counts, as is currently recommended, may not always be clinically adequate.

Fibrin glue-induced eosinophilic pleural effusion after pulmonary resection: A case report

“…Patients with idiopathic eosinophilia are sometimes reported to develop EPE [17] , [18] . In this case, the patient's comorbidity was secondary eosinophilia, and the use of fibrin glue may have induced the development of EPE.…”

Eosinophilic pleural effusion in an eleven-year-old boy

“…Reports are published regarding parasite infected 4 or idiopathic 5 cases. Association with subcutaneous cysticercosis, 6 giardiasis, 7 and idiopathic hypereosinophilic syndromes 8 are reported. PE with helminthic infestation including paragonimiasis has been reported from developing countries.…”