Hypereosinophilic Syndrome Associated with the Onset of Rheumatoid Arthritis: A Case Report

Jae-hee Park; Won-Seok Lee; Seoung Ju Park; Wan-Hee Yoo

doi:10.4078/jrd.2017.24.3.165

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Park, Lee, Park, and Yoo: Hypereosinophilic Syndrome Associated with the Onset of Rheumatoid Arthritis: A Case Report

Case Report

J Rheum Dis 2017;24(3):165-168.

Published online: 31 October 2017

DOI: https://doi.org/10.4078/jrd.2017.24.3.165

Hypereosinophilic Syndrome Associated with the Onset of Rheumatoid Arthritis: A Case Report

Jae-hee Park¹, Won-Seok Lee², Seoung Ju Park³, Wan-Hee Yoo²

¹Department of Internal Medicine, Chonbuk National University Hospital, Jeonju, Korea

²Division of Rheumatology, Department of Internal Medicine, Chonbuk National University Medical School and Research Institute of Clinical Medicine of Chonbuk National University Hospital, Jeonju, Korea

³Division of Pulmonology and Allergy, Department of Internal Medicine, Chonbuk National University Hospital, Jeonju, Korea

Corresponding to: Wan-Hee Yoo, Division of Rheumatology, Department of Internal Medicine, Chonbuk National University Medical School and Research Institute of Clinical Medicine of Chonbuk National University Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, Korea. E-mail: ywhim@jbnu.ac.kr

Received 6 September 201628 November 2016 Accepted 14 December 2016

This is a Open Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Idiopathic hypereosinophilic syndrome (HES) is a disorder characterized by the sustained overproduction of eosinophils and multiple organ damage. Rheumatologic manifestations of HES are infrequent, but persistent eosinophilia is observed in approximately 10% to 40% of patients with rheumatoid arthritis (RA). This finding may be a result of the RA itself and is often associated with active disease and the presence of extraarticular features. We describe the case of a 48-year-old man affected by HES who subsequently developed RA. Both HES and RA responded rapidly to the corticosteroid and methotrexate therapy. In this patient, the initiation of RA and HES was related, suggesting a common pathogenetic link between these two diseases.

Keywords: Hypereosinophilic syndrome, Rheumatoid arthritis

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Figure 1.

High-resolution computed tomography scan of the lungs reveals subpleural distribution of small hyperdense nodules (black arrow) in the right lower lobe.

Figure 2.

Bone scan shows hot spots in both ankles and wrists, a sign of arthritis. Delayed regional bone images show increased radiotracer uptake in both ankles, both feet, and both wrists.

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