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Hypereosinophilic syndrome presenting with gastrointestinal manifestations
  1. Louis Hinkle,
  2. Nisarg Gandhi,
  3. Ryan Neal and
  4. Victor Narcisse III
  1. Houston Methodist Hospital, Houston, Texas, USA
  1. Correspondence to Dr Victor Narcisse III; vjnarcisse{at}


Hypereosinophilic syndrome (HES) is a spectrum of diseases characterised by an elevated eosinophilic count causing end-organ damage. Differential diagnoses of hypereosinophilia are vast and include drug hypersensitivities, allergies, infections, cancers, autoimmune disorders and rare eosinophilic syndromes. Herein, we describe a case of a patient presenting with gastrointestinal (GI) symptoms including progressive dysphagia, abdominal distension, vomiting, diarrhoea and abdominal pain with significant peripheral eosinophilia who was found to have an overlap HES involving the GI tract. This patient’s eosinophilia was rapidly corrected with intravenous methylprednisolone, and the patient experienced gradual resolution of clinical symptoms with maintenance oral prednisone. Due to the rarity and diverse presentation of HES, there are few large, longitudinal studies that describe disease progression and inform treatment guidelines. This case demonstrates the difficulty in designing a treatment regimen for these patients and emphasises the clinical need for improved understanding of HES.

  • Stomach and duodenum
  • Haematology (incl blood transfusion)
  • Endoscopy

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  • Contributors LH contributed to patient care, writing, acquiring images of biopsies, editing and publishing of the case report. NG contributed to patient care, writing, making the table and graphs, editing, writing the cover letter and publishing of the case report. RN and VN contributed to patient care, writing, editing and publishing of the case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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