Peripheral T-cell Lymphoma-Unspecified (PTCL-U) Presenting with Hypereosinophilic Syndrome and Pleural Effusions

Hypereosinophilic syndrome (HES) is a clinical disorder characterized by persistent eosinophilia and systemic involvement, in which a specific causative factor for the eosinophilia cannot be verified during a certain period of time. There have been only a few reported cases of this syndrome associated with malignant lymphoma. We report a case of peripheral T-cell lymphoma-unspecified with hypereosinophilic syndrome. The patient was a 42-year-old woman with an uncontrolled fever and a sore throat. Eosinophilia was observed on the peripheral blood smear. We confirmed the diagnosis by bone marrow and liver biopsies: A bone marrow aspiration demonstrated markedly increased eosinophils (24.8%), and a liver biopsy demonstrated infiltration by scattered eosinophils and atypical lymphoid cells, which were confirmed to be T-cell lymphoma cells. This case was a distinctive presentation of peripheral T-cell lymphoma with hypereosinophilic syndrome, probably due to a paraneoplastic condition.

Toxocariasis en adulto manifestada como síndrome hipereosinofílico con compromiso neurológico predominante: caso clínico / Toxocariasis manifesting as an hypereosinophilic syndrome with predominant neurological involvement: report of adult case

Hypereosinophilic syndrome is characterized by persistent hypereosinophilia and signs or symptoms due to organ involvement, specially nervous system, heart and skin. It can be primary or secondary to allergies, parasites or cancer. Toxocariasis is an uncommon parasitic disease in adults. There is a variant, called visceral larva migrans, that can involve different organs, and among those, the central nervous system. We report a 61 years old male, with a cerebrovascular disease. There were focalizing symptoms, the CAT scan showed multiple ischemic lesions and a peripheral eosinophilia of 12152 cells/mm3 was present. Anti toxocara IgG antibody titers were 1/1000. The patient was treated with albendazole for 14 days. After a 2 years follow up the patients is in good conditions and, for the first time, his eosinophil count is within normal limits

Larva migrante visceral (toxocariasis humana) causa de hipereosinofilia y granulomas viscerales en el adulto / Visceral larva migrans (human toxocariasis) cause of hypereosinophilia and visceral granulomas in the adults

A 24-year -old woman 2-3 months after a normal parturation presented geophagy. Due to hypermenorrhea she consulted a gynecologist and in a hemogram a 57 percent (6, 893 x mm3) hypereosinophilia was detected. A chest TAC showed bilateral pulmonary nodules. The following tests resulted positive: ELISA IgG for toxocariasis 1: 1000, isohemagglutinins anti A 1:2048 and anti B 1:512. The patient was treated with albendazole and prednisone during 10 days. One month after treatment eosinophilia decreased to 2.590 x mm3 and ELISA IgG for toxocariasis descended to 1:128. Different aspect of human toxocariasis are commented. When hypereosinophia is observed in adult patients, toxocariasis must be checked

Considerações sobre a hipereosinofilia na paracoccidioidomicose infantil: apresentação de um novo caso / Considerations about hypereosinophilia in child: new case presentation

É apresentado o caso de um menino de seis anos de idade, natural e procedente de Paracambi (RJ), cuja doença durava dois meses, com manifestações respiratórias e gerais, como febre, sudorese noturna, anorexia e perda de peso. Posteriormente, surgiram dores abdominais, adenomegalias superficiais e massa abdominal palpável. Os hemogramas efetuados revelaram notáveis hipereosinofilias, o primeiro deles mostrando aproximadamente 24.000 eosinófilos por mm³. O diagnóstico de paracoccidioidomicose foi feito por biópsia de gânglio, tendo o esquema de anfotericina B e sulfametoxazol + trimetoprima conseguido excelente resposta clínica. São discutidas as eosinofilias e hipereosinofilias na PCM, conferindo-se maior ênfase aquelas observadas na infância e fazendo-se considerações sobre seu diagnóstico diferencial