Hypereosinophilic syndrome accompanied with necrosis of finger tips.

We report a case of hypereosinophilic syndrome (HES) with marked eosinophilia (59.7%) and mononeuritis multiplex (upper limbs and buttocks). Necrosis of the finger tips was the primary manifestation which simultaneously occurred on both sides. These clinical manifestations were improved dramatically by subsequent steroid therapy. Interestingly, an elevation of serum tumor necrosis factor (TNF) was observed. These findings suggest that TNF may play a role in the etiology of necrosis of the finger tips.