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Case Reports
. 2023 Jun 9;4(3):e320.
doi: 10.1097/PG9.0000000000000320. eCollection 2023 Aug.

Hypereosinophilic Syndrome with Pulmonary Involvement in Ulcerative Colitis

Anam Bashir  1 , Jose M Cabrera  2 , Mariko Suchi  3 , Barry J Pelz  4
Affiliations
Case Reports

Hypereosinophilic Syndrome with Pulmonary Involvement in Ulcerative Colitis

Anam Bashir et al. JPGN Rep. .

Abstract

Reactive eosinophilia is associated with inflammatory bowel disease and is more common in patients with ulcerative colitis (UC) compared with Crohn's disease. The prevalence rate of peripheral blood eosinophilia in patients with inflammatory bowel disease has been described to be as high as 30%-40% of patients in a pediatric study. The coexistence of hypereosinophilic syndrome (HES) and UC is uncommon. We present a 15-year-old boy with UC associated with HES who presented with chest pain and shortness of breath. Laboratory evaluation showed marked eosinophilia. Alternative causes of eosinophilia including eosinophilic leukemia, infections, or drug-induced eosinophilic pneumonia were ruled out. The patient was ultimately diagnosed with HES responsive to mepolizumab.

Keywords: eosinophilia; hypereosinophilic syndrome; ulcerative colitis.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

FIGURE 1.
FIGURE 1.
Microphotographs of colonic biopsy. The colonic mucosa demonstrates elongated and bifurcated crypts within markedly cellular lamina propria containing increased lymphocytes, plasma cells, eosinophils, and neutrophils. Foci of cryptitis (arrowheads) and a crypt abscess (arrow) are shown in the inset. Hematoxylin and eosin, original magnification ×40, inset ×100.
FIGURE 2.
FIGURE 2.
Chest computed tomography at presentation (A) Bibasilar consolidations and ground glass opacities are seen, mild bibasilar predominant bronchial wall thickening (B) Enlarged right hilar and mediastinal lymph nodes.
FIGURE 3.
FIGURE 3.
Absolute eosinophil count progression at diagnosis of ulcerative colitis (UC), discontinuation of mesalamine, and after treatment with mepolizumab treatment.
See this image and copyright information in PMC

References

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