Hypereosinophilic syndrome presenting as eosinophilic gastroenteritis disorder and splinter hemorrhages: A case report

Figure 1 Cutaneous manifestations and endoscopic findings in the patient with eosinophilic gastrointestinal disorder. A and B: Sections show splinter hemorrhages (arrows) in different nails; C and D: Show terminal ileum and colonic mucosal erythematous erosions (arrows).

Figure 2 Histopathology images. A: Terminal ileal/ileocecal biopsy section shows mucosal lining with marked eosinophil rich infiltrates in the lamina propria. The eosinophils infiltrate the muscularis mucosae; B: Higher magnification (400×) of the duodenum section shows the infiltration of crypt epithelium by eosinophils (arrow); C: Section from the ascending colon lamina propria shows a mild increase in eosinophils; however, no cryptitis or crypt abscess is seen; D: Higher magnification (400×) of the rectum shows crypt lining epithelium infiltrated by eosinophils (arrow).

Figure 3 The classification of hypereosinophilic syndrome as per Simon et al[3]. CSS: Cyberchondria severity scale; IBD: Inflammatory bowel disease; HES: Hypereosinophilic syndrome; CEL: Carboxyl ester lipase. Citation: Simon HU, Rothenberg ME, Bochner BS, Weller PF, Wardlaw AJ, Wechsler ME, Rosenwasser LJ, Roufosse F, Gleich GJ, Klion AD. Refining the definition of hypereosinophilic syndrome. J Allergy Clin Immunol 2010; 126: 45-49.