DOI: https://doi.org/10.36347/sjmcr.2026.v14i03.062

Pages: 573-576

Hypereosinophilic syndrome (HES) is a disorder characterized by blood eosinophilia >500 cells/mm³ associated with visceral involvement in patients without any secondary cause of eosinophilia. Renal involvement during this syndrome is rare. We report the case of a 51-year-old patient hospitalized for a glomerular syndrome secondary to hypereosinophilia. Clinical examination revealed grade 2 hypertension and generalized maculo-erythematous skin lesions. Paraclinical investigations showed proteinuria of 2.25 g/24 h, renal insufficiency with serum creatinine at 23 mg/L, microscopic hematuria, and hypereosinophilia at 17.693 cells/mm³ with a negative etiological work-up. Skin biopsy concluded to eosinophilic dermatitis with granuloma surrounding collagen necrosis. Bone marrow biopsy showed a rich, hyperplastic marrow with hypereosinophilia. Kidney biopsy concluded to focal and segmental hyalinosis (FSH), classic variant, with chronic tubulointerstitial involvement estimated at 15–20% and focal inflammatory infiltrate predominantly lymphocytic without vascular lesions. The patient received high-dose corticosteroid therapy and a nephroprotective treatment. At 6 months, the evolution was marked by the disappearance of proteinuria and stable renal function. Renal involvement during hypereosinophilic syndrome is uncommon. In our case, the clinical and histological findings support focal and segmental hyalinosis. Corticosteroid therapy combined with nephroprotection allowed remission.