Idiopathic Hypereosinophilic Syndrome in a Patient with End-Stage Renal Disease

Idiopathic hypereosinophilic syndrome (IHES) occurring concurrently with end-stage renal disease (ESRD) is rarely reported, and its diagnosis and management present notable challenges.

This case report describes a 79-year-old male with ESRD, undergoing maintenance hemodialysis for two years, who presented with persistent pruritus, interstitial pneumonia, and decreased muscle strength. Laboratory investigations revealed sustained eosinophilia (4.39 x 10⁹/L).

Following the exclusion of secondary causes such as infections and malignancies, a diagnosis of IHES was established. A treatment course consisting of low-dose prednisone (0.3 mg/kg/day) for five days led to a 71.2% reduction in eosinophil count (p < 0.01) and a 62.5% decrease in pruritus score (p < 0.05). Complete remission was attained within one month of initiating therapy.

This case underscores the importance of multidisciplinary management in patients with ESRD complicated by IHES and indicates that low-dose glucocorticoids may serve as a safe and effective first-line treatment option.