Differential Diagnosis in a Case with Liver Lesion: Hypereosinophilic Syndrome or Eosinophilic Granulomatosis Polyangiitis

Tükek N. B., Bilgin S., Bavunoğlu I.

Türkiye Klinikleri Journal of Case Reports, cilt.33, sa.1, ss.9-13, 2025 (TRDizin)

Özet

Hypereosinophilia is a common hematological abnormality often associated with parasitic infections, allergic diseases, drug reactions and neoplasms. When persistent eosinophilia is accompanied by organ involvement (e.g., heart, lungs, skin) and secondary causes are excluded, it may indicate primary hypereosinophilic syndrome (HES). Eosinophilic granulomatosis with polyangiitis (EGPA), a systemic vasculitis characterized by eosinophilic infiltration, necrotizing vasculitis, and refractory asthma, shares many clinical features with HES, particularly in the early stages. This overlap can make differentiating between the two conditions challenging without clear vasculitic signs. We present a case report highlighting the complex interplay between HES and EGPA, underscoring the diagnostic challenges in distinguishing these conditions.