Idiopathic hypereosinophilic syndrome presenting as cholestatic liver disease

We report the case of a 34-year-old white man with recurrent episodes of abdominal pain, cholestasis and eosinophilia. The diagnosis of idiopathic hypereosinophilic syndrome (IHS) was made after exclusion of all known causes of eosinophilia. Liver biopsy revealed an eosinophilic infiltrate with biliary damage. The patient recovered after prednisolone treatment. We review the literature on the association between IHS and liver disease.