[Fainting after drinking a glass of whiskey-soda...]

Alcohol intolerance is a rare syndrome that usually involves pain, pruritus, or vasomotor phenomena consecutive to moderate alcohol intake. This syndrome may unmask various malignancies, especially Hodgkin's disease or non-Hodgkin lymphoma, and carcinoma of the cervix.

A patient who became unconscious after drinking a glass of whiskey-cola was explored for alcohol intolerance. High-level hypereosinophilia was discovered. The diagnosis of idiopathic hypereosinophilia was retained after extensive evaluation.

Idiopathic hypereosinophilia may be a premalignancy expression of a lymphoproliferative disorder. In our patient, who also had alcohol intolerance known to be associated with later diagnosis of malignancy, lymphocyte phenotype studies revealed an abnormal population. However, rearrangement studies of T-cell and B-cell receptors, as well as bone marrow cytology and histology did not enable identification of a lymphoproliferative disorder. This patient will require close follow-up due to the risk of developing a lymphoproliferative disorder.