Systemic lupus erythematosus and hyper-eosinophilic syndrome: an unusual association.

A 34-year old woman with dizziness, headache and both upper and lower extremities weakness was admitted to hospital. She had a history of photosensitivity but no asthma or allergy. On physical examination, malar rash and livedo reticularis were noted. White blood cell count was 18500/microL with 7585 eosinophils (41%). She also had positive antinuclear antibody (ANA), anti-double stranded DNA antibody (anti-ds-DNA antibody) and anticardiolipin antibody (aCL antibody). Echocardiography revealed left and right ventricular obliteration with fibromatous biventricular endothelial thickening. Brain MRI showed changes in favour of white matter ischaemia and lacunar infarction. Hypereosinophilic syndrome (HES) and systemic lupus erythematosus may be considered to have occurred concurrently in this patient.