Published online Oct 6, 2019. doi: 10.12998/wjcc.v7.i19.3145
Peer-review started: March 15, 2019
First decision: July 30, 2019
Revised: September 3, 2019
Accepted: September 11, 2019
Article in press: September 11, 2019
Published online: October 6, 2019
Processing time: 199 Days and 10.3 Hours
Hypereosinophilia (HE) is a heterogeneous disease of unknown etiology in which tissue and organ injury is inflicted by excess numbers of circulating or infiltrating eosinophils. Herein, we describe a patient with rare organ damage due to HE and review the pertinent literature.
A 43 year-old Chinese man with a 13-year history of eosinophilia and shortness of breath for 7 d presented to our hospital. During the course of his illness, the patient variably presented with gastrointestinal symptoms, eczema, vitiligo, mastitis, joint symptoms, nephrotic syndrome, and interstitial pneumonia. The chronic mastitis proved burdensome, necessitating bilateral mastectomy. HE was diagnosed by repeat bone marrow biopsy, and a kidney biopsy showed focal segmental glomerulosclerosis. Intermittent steroidal therapy is typically initiated to relieve such symptoms, although relapse and organ involvement often ensue once treatment is withdrawn. We administered methylprednisolone sodium succinate (40 mg/d) intravenously for 3 d, followed by oral tablets at the same dose. Subsequent computed tomography (CT) of the chest CT showed relative improvement of the interstitial pneumonia. The patient is currently on a continuous regimen of oral steroid, and his condition is stable.
HE is heterogeneous condition. This is the first reported case of bilateral mastectomy in a male patient with longstanding HE.
Core tip: Hypereosinophilia (HE) is a heterogeneous disease of unknown etiology in which excessive circulating and infiltrating eosinophils cause injury to bodily tissues and organs. We have treated a male patient with HE and unusual organ involvement, namely, mastitis, nephrotic syndrome, and interstitial pneumonia. Intermittent glucocorticoid therapy may relieve symptoms, but relapses and renewed organ damage are common after withdrawal. This particular patient is currently stable on a continuous oral steroid regimen. This is the first reported case of bilateral mastectomy in a male patient with HE.