PANCREATITIS, ASCITES AND DIARRHEA DUE TO IDIOPATHIC HYPEREOSINOPHILIC SYNDROME

We report a new case of idiopathic hypereosinophilic syndrome with mul tivisceral digestive failure. After on erroneous diagnosis of pancreat ic cancer, the pathological examination of pancreaticoduodenectomy spe cimen demonstrated pancreatic fibrosis with eosinophilic infiltration without gastritis or duodenitis. The diagnosis of idiopathic hypereosi nophilic syndrome was made three months later upon the classical crite ria: a) blood eosinophilia of 1.5 G/L or more, persisting for more tha n 6 months; b) lack of evidence for any other recognised cause of eosi nophilia; c) multiple organ systemic involvement: rheumatologic, cutan eous and digestive (pancreatitis, ascites and diarrhoea); d) previous history of allergic disease and increased plasmatic IgE levels; e) abs ence of leukemic markers. This case emphasises the difficulty in class ifying eosinophilic infiltration of the gut and the possibility of tra nsitional forms between eosinophilic gastro-enteritis and idiopathic h ypereosinophilic syndrome. We argue that in case of eosinophilic infil tration of the gut, systematic research of multiple organ systemic inv olvement is mandatory.