SHM Converge Scientific Abstract ePoster Gallery-Rapidly Progressive Hypereosinophilic Syndrome: A Potential Late Complication of Covid-19

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This case report describes a previously healthy 48-year-old man who developed rapidly progressive hypereosinophilic syndrome (HES) about 30 days after recovering from COVID-19, suggesting a possible late complication of SARS-CoV-2 infection. He presented with recurrent hospitalizations for fever, chills, diffuse abdominal pain, nausea, vomiting, watery diarrhea, pruritic erythematous rash, and Raynaud’s phenomenon.<br /><br />Over the course of two hospitalizations, his leukocytosis and eosinophilia worsened dramatically, with eosinophil counts rising as high as 38,000 and WBC peaking at 51,000. Extensive infectious, autoimmune, and hematologic workup was largely negative, including stool studies, CSF studies, blood cultures, HIV, hepatitis panel, ANA, cANCA, and evaluation for parasitic infections. FISH testing found no evidence of common clonal eosinophilic mutations or rearrangements, and bone marrow biopsy showed prominent eosinophils without other major abnormalities. Endoscopy and colonoscopy revealed chronic inflammation with increased eosinophils, supporting organ involvement.<br /><br />The patient met criteria for idiopathic HES, and after high-dose corticosteroid therapy, his WBC and eosinophil counts fell rapidly, with marked symptomatic improvement within hours. He was discharged on a steroid taper and remained stable.<br /><br />The authors emphasize that HES is a rare multisystem disorder with significant risk of thrombosis and cardiac complications, and that persistent eosinophilia with multiorgan symptoms after COVID-19 should prompt consideration of HES. Early recognition and treatment are important because corticosteroids are highly effective in inducing remission.

Asset Subtitle

Ryan Crane

Meta Tag

Author List Bradley Greib, Otto Leiti, Ryan Crane

Category Clinical Vignettes

Concept Hypereosinophilic Syndrome

Concept Eosinophilia

Concept High-Dose Corticosteroid

Concept Organ damage

Concept Idiopathic Hypereosinophilic Syndrome

Distinguished Non-Finalist

Presenter Organization Central Michigan University College of Medicine

Presenting Author Ryan Crane

Track Adult

Keywords

hypereosinophilic syndrome

COVID-19

SARS-CoV-2

eosinophilia

corticosteroid therapy

idiopathic HES

multisystem disorder

abdominal pain

rash

Raynaud phenomenon

Hypereosinophilic Syndrome

Eosinophilia

High-Dose Corticosteroid

Organ damage

Idiopathic Hypereosinophilic Syndrome