SHM Converge Scientific Abstract ePoster Gallery-Cough, Weight Loss, and Miliary Nodules: Hypereosinophilic Syndrome After Covid-19

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This case describes a 39-year-old man with 9 months of productive cough, progressive shortness of breath, and weight loss beginning after a mild SARS-CoV-2 infection. He had immigrated from Mexico and worked in a cement factory. On exam, he had lung crackles and marked hepatosplenomegaly. CT imaging showed bilateral ground-glass and consolidative lung opacities, nodular interlobular septal thickening, diffuse miliary nodules, and massive enlargement of the liver and spleen.<br /><br />Extensive infectious and autoimmune testing was negative. Biopsies from bronchoscopy and upper endoscopy showed tissue infiltration by eosinophils. Bone marrow biopsy demonstrated massive eosinophilic infiltration, with 95% eosinophils and atypical morphology. Additional testing identified the PDGFRA:FIP1L1 fusion on FISH, confirming a myeloproliferative hypereosinophilic syndrome.<br /><br />The patient improved rapidly with steroids, and later received imatinib in hematology clinic. The case highlights the importance of considering a single systemic cause for multisystem disease, especially when eosinophilia is accompanied by organ involvement. It also emphasizes that persistent pulmonary symptoms, hepatosplenomegaly, and tissue infiltration after negative infectious workup should prompt evaluation for clonal eosinophilic disorders.

Asset Subtitle

Jack Badawy

Meta Tag

Author List Ameer Ahmed, Christian Inchaustegui, Jack Badawy

Category Clinical Vignettes

Concept Myeloproliferative Hypereosinophilic Syndrome

Concept Eosinophilia

Concept End-Organ Damage

Concept FIP1L1-PDGFRA Mutation

Concept Imatinib

Distinguished Non-Finalist

Presenter Organization UT Health San Antonio

Presenting Author Jack Badawy

Track Adult

Keywords

hypereosinophilic syndrome

PDGFRA:FIP1L1 fusion

eosinophilia

hepatosplenomegaly

ground-glass opacities

miliary nodules

productive cough

imatinib

bone marrow biopsy

clonal eosinophilic disorder

Myeloproliferative Hypereosinophilic Syndrome

Eosinophilia

End-Organ Damage

FIP1L1-PDGFRA Mutation

Imatinib