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July 13, 1979

Acute Hypereosinophilic SyndromeSuccessful Treatment With Vincristine, Cytarabine, and Prednisone

Author Affiliations

From the Hematology Division, Department of Medicine, Henry Ford Hospital, Detroit.

JAMA. 1979;242(2):175-176. doi:10.1001/jama.1979.03300020045027

WE describe here a young woman with hypereosinophilic syndrome (HES) who had a high peripheral WBC count, circulating early eosinophilic forms without blast forms, mental confusion with delusions bordering on coma, and severe cardiac manifestations. She successfully responded to a single course of vincristine sulfate, cytarabine, and prednisone therapy after high-dose prednisone therapy failed.

Report of a Case  A 31-year-old woman had a six-week history of weakness, night sweats, intermittent fever, occipitoparietal headaches, paresthesia, and dyspnea. Confusion, emotional lability, and severe heart failure had developed over the previous four days. History disclosed allergies to penicillin and aspirin, mescaline and LSD abuse, hepatitis eight years previously, and chronic asthma controlled adequately with an epinephrine inhaler.Noteworthy findings on physical examination included marked pallor, extreme lethargy, anterior cervical adenopathy, retinal hemorrhages, engorged breasts due to lactation, and pedal edema. Vital signs were normal except for a pulse rate of 100 beats per