Testing, testing, testing: an insidious hypereosinophilia

Aim of the study: This case focuses on the difficulty in recognizing this rare entity characterized by systemic vasculitis in patients with history of asthma. Clinical case: We report a case of a 46-year-old man with history of allergic rhinitis and referred episodes of shortness of breath recognizing as acute bronchitis who presented with fever, skin eruption, peripheral eosonophilia, muscle weakness, abdominal pain and progressively dyspnea.
Methods: Chest radiograph and computed tomography on admission showed consolidation in both lung fields and pericardial effusion. P-serum ANCA were positive. Neurological examination revealed mononeuritis multiplex. A skin biopsy was performed with presence of eosinophil granulocytes. The condition did not respond to antibiotics. He was supposed to have vasculitis and steroid treatment was started at a dose of 1 mg/kg; eosinophilia decreased but there was no clinical improvement. Abdominal pains were progressively more severe; emergency laparotomy revealed ileum infiammation, histopathological examination was consistent with Churg-Strauss syndrome.