Hypereosinophilic Syndrome after Surgery for Eosinophilic Chronic Rhinosinusitis: A Case Report

Hypereosinophilic syndrome (HES) is a rare disease in which eosinophilia causes organ damage and dysfunction. We describe a case of HES that developed during follow-up for eosinophilic rhinosinusitis. A 61-year-old woman presented with rhinorrhea, nasal obstruction, sneezing, snoring, and aural fullness. Endoscopic endonasal surgery, inferior turbinectomy, and septoplasty were performed for eosinophilic chronic rhinosinusitis, allergic rhinitis, and deviated nasal septum during the year she first visited our hospital. Nine months after surgery, she presented with a fever (37.2-38℃) of 2 weeks' duration, bilateral numbness of the lower leg, and lassitude. On the basis of her clinical course, we were able to differentiate her condition from eosinophilic granulomatosis with polyangiitis (EGPA), and HES was diagnosed based on high eosinophil counts and bone marrow puncture results. While treating eosinophilic chronic rhinosinusitis, otorhinolaryngologists must evaluate both the general condition of the patient and affected sites and consider the possibility that a systemic disorder such as EGPA or HES may develop during the clinical course.