EXTENSIVE ORAL INVOLVEMENT IN HYPEREOSINOPHILIC SYNDROME

Hypereosinophilic syndromes (HES) are characterized by blood hypereosinophilia and clinical manifestations attributable to eosinophilia. Oral ulcers are rarely reported as clinical features of HES. The Hematology Unit referred a 30-year-old male patient with multiple oral ulcers lasting for 3 months. The patient also presented with persistent blood hypereosinophilia, together with sharply demarcated skin ulcers. Myelogram was compatible with chronic myeloproliferative syndrome with eosinophilia, and BCR/ABL was positive, reinforcing the diagnosis of HES. A biopsy of an oral lesion was performed, evidencing an extensive eosinophilic inflammatory infiltrate compatible with oral lesion of HES. The patient started imatinib 400 mg and intralesional steroid infiltration, with limited benefit. After 90 days he stopped imatinib and started hydroxyurea, with an adequate resolution of the oral lesions but no hematologic effect. Subsequently, he presented with respiratory discomfort and died of severe candidemia.