Bhasi A, Patnaik I, Panda PK, Singh A. Hypereosinophilic syndrome presenting as eosinophilic gastroenteritis disorder and splinter hemorrhages: A case report. World J Gastrointest Pharmacol Ther 2022; 13(2): 23-29 [PMID: 35433097 DOI: 10.4292/wjgpt.v13.i2.23]
Corresponding Author of This Article
Prasan Kumar Panda, MBBS, MD, Associate Professor, Department of Internal Medicine, All India Institute of Medical Sciences, Rishikesh 249203, Uttarakhand, India. motherprasanna@rediffmail.com
Research Domain of This Article
Allergy
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Ankith Bhasi, Prasan Kumar Panda, Department of Internal Medicine, All India Institute of Medical Sciences, Rishikesh 249203, Uttarakhand, India
Itish Patnaik, Department of Gastroenterology, All India Institute of Medical Sciences, Rishikesh 249203, India
Ashok Singh, Department of Pathology, All India Institute of Medical Sciences, Rishikesh 249203, India
Author contributions: Bhasi A collected all data; Bhasi A, Panda PK and Singh A wrote the manuscript; Bhasi A, Patnaik I and Singh A contributed to the analysis; Bhasi A, Patnaik I, Panda PK, and Singh A contributed to approval; Patnaik I collected endoscopy data, reviewed the manuscript; Panda PK collected data, critically reviewed; Singh A collected pathology data.
Informed consent statement: The patient gave informed consent to share his clinical images and details including laboratory reports.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Prasan Kumar Panda, MBBS, MD, Associate Professor, Department of Internal Medicine, All India Institute of Medical Sciences, Rishikesh 249203, Uttarakhand, India. motherprasanna@rediffmail.com
Received: August 2, 2021 Peer-review started: August 2, 2021 First decision: October 15, 2021 Revised: October 31, 2021 Accepted: January 22, 2022 Article in press: January 22, 2022 Published online: March 5, 2022 Processing time: 211 Days and 8.4 Hours
Abstract
BACKGROUND
Eosinophilia and related organ damage are extensively studied hot topics among rare disorders. Any addition to the cohort of available case reports of the same will be adding knowledge for better management of this less known entity.
CASE SUMMARY
In this article, we describe a 27-year-old Indo-Aryan man who presented with abdominal pain, abdominal distension, and loose stools for variable days. He had splinter hemorrhages in the majority of fingernails. He was diagnosed with predominant eosinophilic gastrointestinal involvement with bowel obstruction and ascites, and was managed with intravenous immunoglobulin. He was subsequently treated with oral low dose steroid therapy and responded completely.
CONCLUSION
Our experience is evidence that prompt management of this hypereosinophilic lethal gastrointestinal (all three layers) infiltrative disease provides a cure and avoids complications. Splinter nail hemorrhages may be seen in the same disease.
Core Tip: This case reveals the wide spectrum of atypical manifestations of hypereosinophilic syndrome. Clinicians must be vigilant in order to diagnose primary instead of secondary eosinophilia as the former can cause diffuse organ infiltration and widespread tissue damage. Eosinophilic gastrointestinal disorder can present with involvement of all three layers of the gastrointestinal tract. Hypereosinophilic syndrome can also present with splinter hemorrhages. Prompt management of this lethal infiltrative disease provides a cure and avoids organ complications.
