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A 12-year-old boy was evaluated in the hematology clinic of this hospital because of fatigue and peripheral-blood eosinophilia. For one week, he had had fatigue that had caused him to miss school, and his appetite had decreased. He also had intermittent cramping, pain in his arms and legs, and anterior chest pain that was worse with movement, deep breathing, and coughing. The patient's mother noted that he had felt warm; the maximum documented temperature was 38.3°C. He had no nausea, vomiting, changes in stool or urinary habits, or night sweats. He took ibuprofen and acetaminophen, both of which resulted in
Differential Diagnosis
Infectious Diseases
Disorders of the Immune System
Toxins, Drugs, and Environmental Factors
Endocrine Abnormalities
Inherited Disorders
Hypereosinophilic Syndromes
Cancer
End-Organ Damage in Hypereosinophilic Syndromes
Clinical Diagnosis
Pathological Discussion
Discussion of Management
Anatomical Diagnosis
Source Information
From the Division of Pediatric Oncology (M.S.H.) and the Department of Pathology (R.P.H.), Massachusetts General Hospital; and the Departments of Pediatrics (M.S.H.) and Pathology (R.P.H.), Harvard Medical School.
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