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Endobronchial Involvement in Idiopathic Hypereosinophilic Syndrome

Parenchymal lung involvement in eosinophilic syndromes (ES) is frequent; however, it is rarely accompanied by tracheobronchial lesions. The etiologies of ES are infectious [parasites and aspergillus (allergic bronchopulmonary aspergillosis)], rheumatologic disease (antineutrophil cytoplasmic antibody–related vasculitis), drug-associated reaction, acute eosinophilic pneumonia, chronic eosinophilic pneumonia (CEP), and hypereosinophilic syndrome (HES).1 We present the case of a 41-year-old nonsmoking gentleman with a 3-week history of muscle weakness and pain in his right forearm. In addition, he reported a mild dry cough, no fevers, and no dyspnea. He had a past medical history of allergic rhinitis. Medications: none. Allergies: non-steroidal anti inflammatory drugs. His past family history was remarkable for his father being diagnosed with idiopathic HES several years prior. Upon physical