Clin Endosc.  2012 Nov;45(4):444-447.

A Hypereosinophilic Syndrome Presenting as Eosinophilic Colitis

• Jeon YW
• Hong SJ
• Kim HJ
• Han JP
• Kim HK
• Ko BM
• Park SK
• Lee MS

Abstract

Hypereosinophilic syndrome (HES) has three defining features: marked hypereosinophilia for at least 6 months, no confirmed etiology for the eosinophilia, and eosinophilia-related symptoms or organ dysfunction. However, a shorter period of hypereosinophilia with symptoms requiring eosinophil-lowering therapy is also acceptable. We report a case of HES presenting as eosinophilic colitis. Although hypereosinophilia was present for 3 months, this patient needed to be treated with eosionphil-lowering therapy for severe hematochezia. After systemic corticosteroid therapy, symptoms caused by organ involvement were dramatically improved.

Keyword

Hypereosinophilic syndrome; Colon; Steroids

MeSH Terms

Colitis
Colon
Eosinophilia
Eosinophils
Gastrointestinal Hemorrhage
Humans
Hypereosinophilic Syndrome
Steroids
Steroids

Figure

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  Fig. 1 Endoscopic findings. (A) Colonoscopy showed erythematous mucosal change with disappearance of normal vascular markings and easy-touch bleeding throughout the entire colon. (B) Esophagogastroduodenoscopy showed erythematous lesions on the antrum of the stomach.

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  Fig. 2 Microscopic findings. There was an intense infiltration of the mucosa by eosinophils (A, H&E stain, ×100). Higher magnification showed the eosinophils aggregate in the lamina propria or extended into the epithelium (B, H&E stain, ×400).

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  Fig. 3 Computed tomography (CT) findings. (A) Chest CT showed nodular infiltration (black arrow) on the right lung. (B) Multifocal patchy enhancing lesions (black arrows) were seen in scans from the arterial phase of liver three-phase CT.

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