Volume 77, Issue 11 (February 2020)
Tehran Univ Med J 2020, 77(11): 724-728 |
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Alinia G, Alimadadi H, Afshoon M, Borhani K, Yaghmaie B, Khodabandeh M. Hypereosinophilia in a three-year-old child: case report. Tehran Univ Med J 2020; 77 (11) :724-728
URL: http://tumj.tums.ac.ir/article-1-10207-en.html
URL: http://tumj.tums.ac.ir/article-1-10207-en.html
Golnaz Alinia1 
, Hosein Alimadadi2 , Maryam Afshoon1 , Katayoun Borhani3 , Bahareh Yaghmaie1 , Mahmoud Khodabandeh * 4
, Hosein Alimadadi2 , Maryam Afshoon1 , Katayoun Borhani3 , Bahareh Yaghmaie1 , Mahmoud Khodabandeh * 4
1- Pediatric’s Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
2- Pediatric Hepatic and Gastrointestinal Diseases Research Center, Pediatric’s Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
3- Department of Pediatric’s Infectious Diseases, Pediatric’s Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
4- Department of Pediatric’s Infectious Diseases, Pediatric’s Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. ,khodabandeh@farabi.tums.ac.ir
2- Pediatric Hepatic and Gastrointestinal Diseases Research Center, Pediatric’s Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
3- Department of Pediatric’s Infectious Diseases, Pediatric’s Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
4- Department of Pediatric’s Infectious Diseases, Pediatric’s Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. ,
Abstract: (2292 Views)
Background: Hypereosinophilic syndrome is commonly found in various diseases such as allergic diseases, parasitic diseases, malignancies, etc. Fasciolosis may present with different clinical features, and it can make a difficult diagnosis of the disease. Laboratory manifestations of fascioliasis are eosinophilia. The purpose of this report was to introduce a child with hypereosinophilia that her diagnosis was fascioliasis.
Case Presentation: The patient was a 3-year-old girl who was referred for prolonged fever (more than two weeks) and abdominal pain from another medical center, and she was hospitalized. In abdominal and pelvic ultrasound, splenomegaly was seen and in laboratory tests, she had hypereosinophilia. In the flow cytometry of bone marrow aspiration, the only finding was increased eosinophil level. Abdominal and thoracic a computerized tomography (CT) scans showed an increased size of para-aortic lymph nodes. On her examination, lymphadenopathy was present in the inguinal region. Therefore, a biopsy of an inguinal lymph node was performed to rule out lymphoma. Lymph node biopsy was negative for lymphoma. Fasciola serology was performed for the patient, and the stool exam was collected three times (for one day in between) to rule out parasitic disease, including Fasciola, etc. Due to weakly positive serology Fasciola hepatica, triclabendazole was started for the patient (it was given in two doses, 12 hours apart), despite the absence of Fasciola parasitic eggs in her stool. During hospitalization, the patient’s fever was stopped and by starting the use of mentioned drug, eosinophilia was reduced. The patient received a complete improvement in the follow-up.
Conclusion: In patients with hypereosinophilia, parasitic diseases such as fascioliasis should be considered even if the fecal specimen is negative for Fasciola eggs.
Case Presentation: The patient was a 3-year-old girl who was referred for prolonged fever (more than two weeks) and abdominal pain from another medical center, and she was hospitalized. In abdominal and pelvic ultrasound, splenomegaly was seen and in laboratory tests, she had hypereosinophilia. In the flow cytometry of bone marrow aspiration, the only finding was increased eosinophil level. Abdominal and thoracic a computerized tomography (CT) scans showed an increased size of para-aortic lymph nodes. On her examination, lymphadenopathy was present in the inguinal region. Therefore, a biopsy of an inguinal lymph node was performed to rule out lymphoma. Lymph node biopsy was negative for lymphoma. Fasciola serology was performed for the patient, and the stool exam was collected three times (for one day in between) to rule out parasitic disease, including Fasciola, etc. Due to weakly positive serology Fasciola hepatica, triclabendazole was started for the patient (it was given in two doses, 12 hours apart), despite the absence of Fasciola parasitic eggs in her stool. During hospitalization, the patient’s fever was stopped and by starting the use of mentioned drug, eosinophilia was reduced. The patient received a complete improvement in the follow-up.
Conclusion: In patients with hypereosinophilia, parasitic diseases such as fascioliasis should be considered even if the fecal specimen is negative for Fasciola eggs.
Keywords: case reports, child, Fasciola hepatica, hypereosinophilia, parasitic diseases, triclabendazole
Type of Study: Case Report |
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