title: Generalized Recalcitrant Pruritus as the Presenting Manifestation of Hypereosinophilic Syndrome.
abstract: OBJECTIVE
  Pruritus is a frequent occurrence in dermatology, and investigation is often unrevealing. The authors report the case of a 65-year-old man presenting with generalized recalcitrant pruritus as the presenting manifestation of hypereosinophilic syndrome.
  
  
  RESULTS
  A 65-year-old man developed intractable pruritus. Results of polymerase chain reaction clonal rearrangement were positive and led to the diagnosis and treatment. The patient also developed massive pulmonary embolism, which can be caused by chronic eosinophilia.
  
  
  CONCLUSIONS
  This case highlights the importance of investigating patients with pruritus and unexplained persistent eosinophilia. Hypereosinophilic syndrome must be included in the differential diagnosis, which in this case presented initially as intractable pruritus. Polymerase chain reaction clonal rearrangement was key in reinforcing the diagnosis.
authors.affiliation: Laval University, Hôtel Dieu de Québec, CHU, Québec City, QC, Canada ariane.schreiber.1@ulaval.ca.
authors.forename: Ariane
authors.initials: A
authors.lastname: Schreiber
authors.affiliation: Laval University, Hôtel Dieu de Québec, CHU, Québec City, QC, Canada.
authors.forename: Martin
authors.initials: M
authors.lastname: LeBlanc
authors.affiliation: Laval University, Hôtel Dieu de Québec, CHU, Québec City, QC, Canada.
authors.forename: Marie-Marthe
authors.initials: MM
authors.lastname: Thibeault
authors.affiliation: Laval University, Hôtel Dieu de Québec, CHU, Québec City, QC, Canada.
authors.forename: Steve
authors.initials: S
authors.lastname: Mathieu
mesh_terms: D000368:Aged; D002908:Chronic Disease; D006801:Humans; D017681:Hypereosinophilic Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D011537:Pruritus / Q000209:etiology*; D012008:Recurrence
keywords: PCR clonal rearrangement; eosinophilia; generalized pruritus; hypereosinophilic syndrome; hypereosinophilic syndrome lymphocytic variant; pulmonary embolism