Foreman Nicole, Neves Ana, Rocha João, Dias Manuela, Almeida Jorge S
Intensive Care, Unidade Local De Saúde De São João, Porto, PRT.
Internal Medicine, Unidade Local De Saúde De São João, Porto, PRT.
Cureus. 2024 Dec 30;16(12):e76638. doi: 10.7759/cureus.76638. eCollection 2024 Dec.
Hypereosinophilic syndrome (HES) is marked by eosinophilic infiltration and the release of inflammatory mediators that cause damage to multiple organs. Despite careful evaluation of hypereosinophilia, the etiology of most cases remains undefined. Eosinophils may cause damage in almost all organs, and most patients present with dermatological manifestations. We report a case of a 70-year-old man with a history of rheumatoid arthritis, who is under treatment with rituximab and leflunomide. He presented with generalized erythematous and pruritic cutaneous lesions that became scaly and hypopigmented, some of which were ulcerative and infected. Peripheral blood hypereosinophilia was noted (>6.0x10 eosinophils/L). Primary and secondary causes of hypereosinophilia, including neoplasms and infections, were excluded, and idiopathic HES was assumed. The patient was started on oral prednisolone with complete resolution of the lesions.
高嗜酸性粒细胞综合征（HES）的特征是嗜酸性粒细胞浸润以及炎症介质的释放，这些会对多个器官造成损害。尽管对嗜酸性粒细胞增多症进行了仔细评估，但大多数病例的病因仍不明确。嗜酸性粒细胞几乎可损害所有器官，大多数患者会出现皮肤表现。我们报告一例70岁男性，有类风湿关节炎病史，正在接受利妥昔单抗和来氟米特治疗。他出现了全身性红斑和瘙痒性皮肤损害，这些损害后来变得鳞屑状且色素减退，其中一些是溃疡性且伴有感染。外周血嗜酸性粒细胞增多（>6.0×10嗜酸性粒细胞/L）。排除了嗜酸性粒细胞增多症的原发性和继发性病因，包括肿瘤和感染，推测为特发性HES。患者开始口服泼尼松龙，皮损完全消退。
