Hypereosinophilic syndrome (HES)

Can an internal medicine doctor diagnose Hypereosinophilic syndrome?
I have had a severe full body rash for 8 months and swollen inguinal lymph nodes for 3 months. I had an ultrasound and biopsy on my lymph nodes and they said its not cancer. My allergist thinks I have hypereosinophillic syndrome (HES) and sent me to a hematologist. I dont have a gene mutation and was told by my allergist I need a bone marrow biopsy to be diagnosed. They took 3 weeks to review my case and told me they would not see me because they do not diagnose or treat anything to do with high eosinophils. This clinic has the only hematologists in my insurance network. My PCP and allergist say they cant do anything else, and that a hematologist has to diagnose me. Should I see an internal medicine doctor? Any other way to get diagnosed? I have never been so miserable and desperately need help

Thank you I would definitely appreciate any information on this you could pass along to me.

Oh I am so sorry. Yes I was told that when they can’t figure out the cause they label it HES. I have been told it is a rare condition and of all the doctors I am seeing I am their first ever HES patient. I heard Nucala is a good drug to lower EOS I am trying to get on it but I have to be diagnosed for six months before I’m approved. So I am on prednisone to keep my levels normal.

As you are I am reading a lot but nothing seems positive about it and there is no good reason given for it to happen. The danger with high EOS is the damage it can cause to our organs. Which is why it is so important to have the EOS controlled. It does for some unknown reason pop up out of no where which to me is so strange. My very thick file was sent to a conference about a month ago where the attendees reran all the bone marrow testing and reevaluated what caused the elevation. Other than coming up with no cancers(thank the good lord) they had no diagnosis other than possibly HES.

I pray your grandson and you find answers and hope that it remains stable with nothing further that happens. Nucala should do that for him.

If I find anything out that could help you I will share. Keep strong.

Yes they tested him for allergies and only thing that showed was that he is allergic to pet dander, dust mites, grass and some type of weeds. He was acting lethargic for about two weeks prior to the trip to the er and he was cold all of the time and had headaches and didn't want to eat much. We thought he was tired from playing outside or either coming down with a cold but he never had fever so we kinda brushed it off. He woke up with a knot on his neck the size of a tennis ball so I rushed him to the er. Those were the only symptoms. Once in the hospital he started having fevers and bad night sweats. They tested and treated him for parasites they all came back negative. They have no idea what is causing his high eosinophils. His eosinophil count got up to 98,000 for two weeks and then they finally gave him the nucala shot. They keep telling us this is a serious condition and it's rare in children his age. The Dr's said they have never had a case like this before and have ran so many test on him because they can't find out what is causing it. He sees an immunologist dr a pulmonologist dr and an oncologist monthly and has labs ever other week to check his levels. I have been reading up on idiopathic hypereosinophilic syndrome but I'm still so confused and worried. We want to know what is causing this and why did it pop up out of no where.

I’m so sorry to hear that about your grandson It mimics what happened to me. However when I was in the ER and admitted I had terrible swelling of my face
Which occurred every day for weeks. It traveled to my neck, shoulders and caused terrible weakness. After many tests and a bone marrow which showed no signs of cancer I was given the diagnosis of HES. Thankfully no organs were damaged from the elevated EOS. I was told that this would be a lifelong condition and that it is considered a pre leukemia condition however in what I have read it is not a common thing to occur. As long as the EOS are controlled the diagnosis should not alter our way of life or for that matter our length of life.

Did they test your grandson for allergies. What caused your grandson to have to go to the ER. Did he have symptoms?

Yes he was tested for cancer but everything came back negative. They only told us that high eosinophils can cause cancer and since his were high for so long its a big possibility. His bone marrow biopsy just came back with very high eosinophils. Every lyphmnode in his body was swollen when he went into the er. He gets another bone marrow biopsy done next month. They were certain he had leukemia when brought into the er but test came back negative. Yes the nucala is working very well. His levels haven't been above 900 with the nucala shot. We give the shot to him from home once a month. He has labs done biweekly now. Everything is so confusing to us they can't give him a prognosis but tell us this will be a lifetime struggle for him and is incurable.

Did they test him for cancer? They did a bone marrow aspiration for me to look for a few cancers all came back negative. My immunologist also is suggesting nucala for me rather than life term prednisone. Is nucala working for your grandson? What makes them think there is a cancer possibly?

Hello, my grandson recently was diagnosed with idiopathic hypereosinophilic syndrome and its all new to us as well, but they started him on a shot called nucala to bring his eosinophils down because he can't take any form of steroids due to him also possibly having cancer. They said his is also pre leukemia condition and the steroids will mask any cancer if it is growing in his body. I don't understand this and I have searched everywhere to help get answers. Your dr should listen to you about the hair dye because the immunologist told us that certain allergies can rise your eosinophil count.

i was also told by the allergist/immunologist that this is a pre leukemia condition because my bone marrow shows a mutation that is seen sometimes in leukemia and lymphoma however i tested negative for this cancer and the oncologist i went to never stated that. also stated it was not an issue. wondering if anyone else has experienced that as well.

Hi, i am reading your post about your wife and I am wondering if possibly this could be what I have. I also had high WBC with high EOS, swelling of face, neck, legs, back and shoulders. had pain but more weakness than pain. the only testing that came back with issues was my lab work and bone marrow showing lots of EOS and the high WBC. once on prednisone the counts started to decrease.