Alshehri SS, Minhaji BI, Pasha MR. Hyperleucocytosis as an unusual presentation of hypereosinophilic pneumonitis with acute respiratory distress syndrome.
SAGE Open Med Case Rep 2022;
10:2050313X221086814. [PMID:
35341105 PMCID:
PMC8943594 DOI:
10.1177/2050313x221086814]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 02/24/2022] [Indexed: 12/03/2022] Open
Abstract
Idiopathic hypereosinophilic syndrome in children is a rare disease. Even with improved
understanding of eosinophilic disorders and recent advances in diagnostic modalities,
evaluation of hypereosinophilia remains challenging due to heterogeneous etiologic
factors. In acute clinical settings, the management plan is often unclear as the condition
is not encountered frequently. It is often associated with leucocytosis, but
hyperleucocytosis causing multiorgan dysfunction in the absence of malignancy is rarely
seen. A previously well 5-year-old boy presented to our emergency room with a 2-week
history of fever, progressive cough and dyspnoea, rapidly progressing to respiratory
failure and acute respiratory distress syndrome. Hyperleucocytosis with hypereosinophilia
on peripheral blood film, bilateral pulmonary infiltrates on X-ray and ground glass
opacities suggested hypereosinophilic syndrome with secondary acute respiratory distress
syndrome. Owing to severe and rapidly increasing leucocytosis, malignancy was highly
suspected, but it was ruled out along with secondary hypereosinophilic syndrome after
extensive investigations, and acute respiratory distress syndrome in this child was
attributed to Idiopathic Hypereosinophilic Syndrome. Eosinophilia had a dramatic response
to high dose corticosteroid therapy. To conclude, in patients with hypereosinophilic
syndrome, possibility of progression to acute respiratory distress syndrome should be
anticipated and managed accordingly.
Collapse