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BMJ Case Reports 2018; doi:10.1136/bcr-2017-222306
  • Rare disease
  • CASE REPORT

Ninety-year-old man with hypereosinophilia, lymphadenopathies and pruritus

  1. Joana Graça4
  1. 1Department of Internal Medicine, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Portugal
  2. 2Department of Hematology, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Portugal
  3. 3Department of Internal Medicine, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Portugal
  4. 4Department of Oncology, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Portugal
  1. Correspondence to Dr José Guilherme Freitas, jfrei1992{at}gmail.com
  • Accepted 22 December 2017
  • Published 10 January 2018

Summary

We report a case of a 90-year-old man with hypereosinophilia, lymphadenopathies and skin lesions, namely lichenification and pruritus. An aetiological investigation was performed, and a bone marrow (BM) biopsy and aspirate showed a hypercellular marrow with hypereosinophilia without dysmorphia or abnormal elements, and the BM and inguinal node’s immunophenotyping denied any presence of abnormal lymphoid cell population. The inguinal node biopsy revealed a multinodular proliferation of large cells S100 and CD1a+, and a diagnosis of Langerhans cell histiocytosis was made. The hypereosinophilia and skin lesions were managed with corticotherapy with substantial improvement of cutaneous lesions and lymphadenopathies and normalisation of eosinophil count. Finally, to define if it is a single or multisystem disease, a skin biopsy will be necessary.

Footnotes

  • Contributors JGF wrote the first concept of the manuscript. AJ, DR and JG critically revised it. After drafting the final version by JGF, all authors approved it for publication.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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