Ultrastructural alterations of the eosinophils in hypereosinophilic syndrome (Hebrew)

A patient with the hypereosinophilic syndrome is described. The main clinical features comprised bronchial asthma, multiple neurological alterations (including right hemiplegia and paresis of the right abducens and left peroneal nerves), congestive heart failure, myalgia and arthralgia. Laboratory tests revealed marked eosinophilia (up to 71%) in the peripheral blood, eosinophilic infiltration of the bone marrow and an accelerated sedimentation rate. Electron microscopic studies of the eosinophiles revealed prominent granules lacking the specific granulation, which could be an expression of immaturity of the lysosomal granules in otherwise mature cells. This is thought to be the first report of ultrastructural alterations in eosinophilic cells in this syndrome. Treatment wih corticosteroids improved the patients condition and decreased the eosinophil count almost to normal. The course of the disease was complicated by perforation of the small intestine, successfully treated by immediate surgery.