title: Hypereosinophilic Syndrome After Liver Transplantation: A Case Report and a Review of the Literature.
abstract: Persistently elevated eosinophil granulocytes in the peripheral blood in children is challenging because of a complex diagnosis especially after solid organ transplantation and can lead to difficulties in finding an underlying causative factor.We report a 12-year-old boy who developed severe hypereosinophilia 11 years after liver transplantation due to biliary atresia. Accompanying symptoms were recurrent fever, fatigue, elevated liver enzymes, abdominal pain, and significant weight loss. After exclusion of secondary causes of eosinophilia, an idiopathic hypereosinophilic syndrome (I-HES) was diagnosed. Treatment with prednisolone resulted in an immediate response with rapid reduction of eosinophils, normalization of liver enzymes, and amelioration of any clinical symptoms. A hypereosinophilic syndrome in patients after liver transplantation is rare, and a broad differential diagnosis has to be considered. Prednisolone may lead to a prompt amelioration of eosinophilia and associated symptoms.
authors.affiliation: 1 Department of Pediatrics, University-Medical Centre Hamburg-Eppendorf, Germany. 2 Department of Pediatric Infectious Diseases, University-Medical Centre Hamburg-Eppendorf, Germany. 3 Department of Pediatric Gastroenterology, Hepatology and Liver Transplantation, University-Medical Centre Hamburg-Eppendorf, Germany. 4 Institute of Pathology, University-Medical Centre Hamburg-Eppendorf, Germany. 5 Department of Pediatric Nephrology and Kidney Transplantation, University-Medical Centre Hamburg-Eppendorf, Germany. 6 Department of Pediatrics, Heidberg-Hospital, Hamburg, Germany.
authors.forename: Wiebke
authors.initials: W
authors.lastname: Aulbert
authors.forename: Robin
authors.initials: R
authors.lastname: Kobbe
authors.forename: Christian
authors.initials: C
authors.lastname: Breuer
authors.forename: Andrea
authors.initials: A
authors.lastname: Briem-Richter
authors.forename: Hansjörg
authors.initials: H
authors.lastname: Schäfer
authors.forename: Florian
authors.initials: F
authors.lastname: Brinkert
authors.forename: Anne
authors.initials: A
authors.lastname: Dettmar
authors.forename: Markus Josef
authors.initials: MJ
authors.lastname: Kemper
authors.forename: Enke
authors.initials: E
authors.lastname: Grabhorn
mesh_terms: D002648:Child; D006801:Humans; D017681:Hypereosinophilic Syndrome / Q000175:diagnosis / Q000209:etiology*; D016031:Liver Transplantation; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis