Open Access, Peer-reviewed
pISSN 2288-0402
eISSN 2288-0410
    Allergy Asthma Respir Dis. 2015 Jan;3(1):77-81. Korean.
    Published online Jan 31, 2015.
    https://doi.org/10.4168/aard.2015.3.1.77
    © 2015 The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma, Allergy and Clinical Immunology
    Case Report

    Idiopathic hypereosinophilic syndrome presenting with urinary frequency, abdominal pain, and diarrhea

    Ja-Kyung Kim, Joo-Hee Kim, Han-Min Park, Yong-Seol Jeong, Chung-Jo Choi, Seong-Kyun Na, Jong-Hyeok Kim, Young-Rim Song, Yong-Il Hwang, Seung-Hun Jang and Ki-Suck Jung
      • Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
    • Correspondence to: Joo-Hee Kim. Department of Internal Medicine, Hallym University Sacred Heart Hospital, 22 Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang 431-796, Korea. Tel: +82-31-380-3719, Fax: +82-31-380-3973, Email: luxjhee@gmail.com
    Received July 17, 2014; Revised September 04, 2014; Accepted September 15, 2014.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/).

    Abstract

    Idiopathic hypereosinophilic syndrome (IHES) is a rare disorder defined by persistent blood eosinophilia, evidence of eosinophil-associated organ dysfunction and absence of secondary causes. Eosinophilic infiltration and its mediator release can cause damage to multiple organs. Although IHES can involve every organ system, bladder involvement is rarely evidenced. We recently reported a case of IHES with both bladder and gastrointestinal tract involvement. A 43-year-old woman visited Hallym University Sacred Heart Hospital complaining of urinary frequency, abdominal pain, and diarrhea for several months. Abdominal pelvic computed tomographic scan showed diffuse wall thickenings in her bladder and colon with small pelvic ascites. Laboratory investigation showed a marked peripheral eosinophilia and tissue biopsies confirmed eosinophilic infiltration in the bladder wall, esophagus, and duodenum. The patient was treated with prednisolone and her eosinophilia and symptoms have gradually improved.

    Keywords
    Hypereosinophilic syndrome; Eosinophilic esophagitis; Enteritis; Cystitis

    Figures

    Fig. 1
    (A) There is diffuse wall thickening of urinary bladder on the abdominal-pelvic computed tomography (axial view). (B) Cystoscopic examination finding shows edematous wall of bladder.

    Fig. 2
    (A) Bladder biopsy shows eosinophilic infiltration (H&E, ×200). (B) Esophageal biopsy presents chronic esophagitis with eosinophilic infiltration (H&E, ×400). (C) Duodenal biopsy of chronic inflammation with a few eosinophils (H&E, ×400).

    Fig. 3
    Treatment and prognosis. A full line means the eosinophil counts of blood. HD, hospital day; PD, prednisolone.

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    MeSH Terms
    Abdominal Pain*
    Adult
    Ascites
    Biopsy
    Colon
    Cystitis
    Diarrhea*
    Duodenum
    Enteritis
    Eosinophilia
    Eosinophilic Esophagitis
    Eosinophils
    Esophagus
    Female
    Gastrointestinal Tract
    Heart
    Humans
    Hypereosinophilic Syndrome*
    Prednisolone
    Urinary Bladder
    Metrics
    Share
    Figures
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