Exudative ascites revealing an Idiopathic Hypereosinophilic Syndrome

Khadija Lamii1*, Ahmed Bellabah1, Wafae Hliwa1, Fouad Haddad1, Mohmed Tahiri1, Wafae
Badre
Page No. 1-4

Eosinophilic ascites may be an important clinical sign of idiopathic hypereosinophilic syndrome
(SHI), and it should be kept in mind in the absence of evidence for any other recognized cause of
eosinophilia. We report a 34-year-old woman, presented for isolated exudative ascites rich in
Eosinophilic Polynuclear. Laboratory tests highlighted a persistent hypereosinophilia at 7191
/mm3. The computerized tomography scan showed moderate ascites. Multiple biopsies revealed
eosinophil count high in sigmoid and descending colon. Bone marrow aspiration showed
hypercellularity with 16% mature eosinophils, without blasts. Cytogenetic analysis showed a
normal karyotype. The expression of a FIP1L1-PDGFRA (FIP1-like 1/ Platelet derived growth
factor receptor alpha) fusion protein and no identifiable etiology for eosinophilia, all these findings
were suggestive of a diagnosis of idiopathic hypereosinophilic syndrome with myeloproliferative
variant and prednisone was started, with good outcomes in clinical and biological. A preventive
treatment with Imatinib was proposed. The patient remained asymptomatic (24-month decline).
Keywords: Idiopathic Hypereosinophilic Syndrome, Eosinophilic Polymorphonuclear, Eosinophilic
ascites, FIP1L1-PDGFR.