Fatal fulminant hypereosinophilic syndrome with a petechial rash in a 16-year-old girl.
Peripheral blood eosinophilia and eosinophilic tissue infiltration characterize the hypereosinophilic syndrome, which if untreated can be fatal. Its manifestations are protean. Often a diagnosis of exclusion, it presents diagnostic challenges. A fatal case of hypereosinophilic syndrome in a 16-year-old girl with petechiae, edema, urticaria, and diffuse erythema unfolded over 2 weeks. The histopathology of the petechiae demonstrated an eosinophilic and mixed cell interstitial and perivascular infiltrate and microthrombi in vessels. There was no evidence of T-cell clonality. Despite treatment with cyclosporine and methylprednisolone, she died. The age group; fulminant, fatal course without neoplasia; striking eosinophilia; and petechial rash are notable.
Scheinfeld
Noah
N
Saint Luke's-Roosevelt Hospital Center, Department of Dermatology, New York, NY 10028, USA. Scheinfeld@earthlink.net
D000293:Adolescent; D016572:Cyclosporine / Q000627:therapeutic use; D004487:Edema / Q000150:complications; D005076:Exanthema / Q000150:complications* / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D017681:Hypereosinophilic Syndrome / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D017093:Liver Failure / Q000150:complications / Q000188:drug therapy; D008775:Methylprednisolone / Q000627:therapeutic use; D011693:Purpura / Q000150:complications* / Q000473:pathology; D051437:Renal Insufficiency / Q000150:complications / Q000188:drug therapy
D016572:Cyclosporine; D008775:Methylprednisolone