Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2019; 7(19): 3145-3152
Published online Oct 6, 2019. doi: 10.12998/wjcc.v7.i19.3145
Hypereosinophilia, mastectomy, and nephrotic syndrome in a male patient: A case report
Jian Wu, Peng Li, Yu Chen, Xiang-Hong Yang, Meng-Yun Lei, Li Zhao
Jian Wu, Department of Anesthesiology, Shengjing Hospital, China Medical University, Shenyang 110004, Liaoning Province, China
Peng Li, Yu Chen, Li Zhao, Department of Respiratory Medicine, Shengjing Hospital, China Medical University, Shenyang 110004, Liaoning Province, China
Xiang-Hong Yang, Department of Pathology, Shengjing Hospital, China Medical University, Shenyang 110004, Liaoning Province, China
Meng-Yun Lei, Department of Endocriology, Shengjing Hospital, China Medical University, Shenyang 110004, Liaoning Province, China
Author contributions: Wu J, Li P, Chen Y, Yang XH, Lei MY, and Zhao L contributed to the manuscript writing and revision.
Informed consent statement: Written informed consent was obtained from the patient.
Conflict-of-interest statement: The authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2013), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yu Chen, MD, PhD, Professor, Department of Respiratory Medicine, Shengjing Hospital, China Medical University, No. 36, Sanhao Street, Shenyang 110004, Liaoning Province, China. chenyusy@hotmail.com
Telephone: +86-18940256915
Received: March 14, 2019
Peer-review started: March 15, 2019
First decision: July 30, 2019
Revised: September 3, 2019
Accepted: September 11, 2019
Article in press: September 11, 2019
Published online: October 6, 2019
Abstract
BACKGROUND

Hypereosinophilia (HE) is a heterogeneous disease of unknown etiology in which tissue and organ injury is inflicted by excess numbers of circulating or infiltrating eosinophils. Herein, we describe a patient with rare organ damage due to HE and review the pertinent literature.

CASE SUMMARY

A 43 year-old Chinese man with a 13-year history of eosinophilia and shortness of breath for 7 d presented to our hospital. During the course of his illness, the patient variably presented with gastrointestinal symptoms, eczema, vitiligo, mastitis, joint symptoms, nephrotic syndrome, and interstitial pneumonia. The chronic mastitis proved burdensome, necessitating bilateral mastectomy. HE was diagnosed by repeat bone marrow biopsy, and a kidney biopsy showed focal segmental glomerulosclerosis. Intermittent steroidal therapy is typically initiated to relieve such symptoms, although relapse and organ involvement often ensue once treatment is withdrawn. We administered methylprednisolone sodium succinate (40 mg/d) intravenously for 3 d, followed by oral tablets at the same dose. Subsequent computed tomography (CT) of the chest CT showed relative improvement of the interstitial pneumonia. The patient is currently on a continuous regimen of oral steroid, and his condition is stable.

CONCLUSION

HE is heterogeneous condition. This is the first reported case of bilateral mastectomy in a male patient with longstanding HE.

Keywords: Hypereosinophilia, Mastectomy, Nephrotic syndrome, Interstitial pneumonia, Case report

Core tip: Hypereosinophilia (HE) is a heterogeneous disease of unknown etiology in which excessive circulating and infiltrating eosinophils cause injury to bodily tissues and organs. We have treated a male patient with HE and unusual organ involvement, namely, mastitis, nephrotic syndrome, and interstitial pneumonia. Intermittent glucocorticoid therapy may relieve symptoms, but relapses and renewed organ damage are common after withdrawal. This particular patient is currently stable on a continuous oral steroid regimen. This is the first reported case of bilateral mastectomy in a male patient with HE.