Complete hematological response with imatinib mesylate in a corticosteroid refractory idiopathic hypereosinophilic syndrome in person living with HIV: A case report
Restricted accessCase reportFirst published online July, 2025
Complete hematological response with imatinib mesylate in a corticosteroid refractory idiopathic hypereosinophilic syndrome in person living with HIV: A case report
We present a case of a 38-year-old person living with HIV (PLHIV) diagnosed with refractory idiopathic hypereosinophilic syndrome (HES). His initial symptoms were pruritic skin rash, dry cough, and diarrhea. The patient was unresponsive to corticosteroid as a first-line therapy. Subsequent treatment with Imatinib mesylate 100 mg per day resulted in excellent and sustained hematological and clinical response, with a likely molecular response as well.
KhouryPAkuthotaPWellerPF, et al.Eosinophilia and eosinophil-related disorder. Middleton’s allergy. 9th ed.Amsterdam: Elsevier, 2020, pp. 1197–1215.
2.
ShomaliWGotlibJ. World Health Organization-defined eosinophilic disorders: 2022 update on diagnosis, risk stratification, and management. Am J Hematol2022; 97(1): 129–148.
3.
GotlibJCoolsJMaloneJMIII, et al.The FIP1L1-PDGFRalpha fusion tyrosine kinase in hypereosinophilic syndrome and chronic eosinophilic leukemia: implications for diagnosis, classification, and management. Blood2004; 103(8): 2879–2891.
4.
ChouASerpaJA. Eosinophilia in patients infected with human immunodeficiency virus. Curr HIV AIDS Rep2015; 12(3): 313–316.
5.
TietzASponagelLErbP, et al.Eosinophilia in patients infected with the human immunodeficiency virus. Eur J Clin Microbiol Infect Dis1997; 16(9): 675–677.
6.
SivaramMWhiteARadcliffeKW. Eosinophilia: clinical significance in HIV-infected individuals. Int J STD AIDS2012; 23(9): 635–638.
7.
Al MohajerMVillarreal-WilliamsEAndradeRA, et al.Eosinophilia and associated factors in a large cohort of patients infected with human immunodeficiency virus. South Med J2014; 107(9): 554–558.
8.
MollerDTanJGauiranDTV, et al.Causes of hypereosinophilia in 100 consecutive patients. Eur J Haematol2020; 105(3): 292–301.
9.
SunderkötterCHZelgerBChenK, et al.Nomenclature of cutaneous vasculitis: dermatologic addendum to the 2012 revised international chapel hill consensus conference nomenclature of vasculitides. Arthritis Rheumatol2018; 70(2): 171–184.
10.
KlionA. Hypereosinophilic syndrome: approach to treatment in the era of precision medicine. Hematology2018; 2018(1): 326–331.
11.
JovanovicJVScoreJWaghornK, et al.Low-dose imatinib mesylate leads to rapid induction of major molecular responses and achievement of complete molecular remission in FIP1L1-PDGFRA–positive chronic eosinophilic leukemia. Blood2007; 109(11): 4635–4640.
12.
PardananiAReederTPorrataLF, et al.Imatinib therapy for hypereosinophilic syndrome and other eosinophilic disorders. Blood2003; 101(9): 3391–3397.
13.
IntermesoliTDelainiFAcerboniS, et al.A short low-dose imatinib trial allows rapid identification of responsive patients in hypereosinophilic syndromes. Br J Haematol2009; 147(5): 681–685.
14.
HelbigGLewandowskiKŚwiderskaA, et al.Exquisite response to imatinib mesylate in FIP1L1-PDGFRA-mutated hypereosinophilic syndrome: a 12-year experience of the Polish Hypereosinophilic Syndrome Study Group. Pol Arch Intern Med2020; 130(3): 255–257.
15.
IqbalNIqbalN. Imatinib: a breakthrough of targeted therapy in cancer. Chemother Res Pract2014; 2014: 357027.
16.
HelbigG. Imatinib for the treatment of hypereosinophilic syndromes. Expert Rev Clin Immunol2018; 14(2): 163–170.
