pituitrin and Eosinophilia

Hyperimmunoglobulin E syndrome (HIES) due to dedicator of cytokinesis8 (DOCK8) deficiency may present in infancy and childhood with different clinical features involving recurrent infections, allergic dysregulation, and autoimmunity.. In this report, we describe a patient who first presented with severe hypereosinophilia and went on to develop the syndrome of inappropriate antidiuretic hormone secretion (SIADH) in the context of a severe herpes infection. Investigation revealed the presence of underlying DOCK8 deficiency presenting with atypical clinical features.. Distinct inflammatory features associated with infections may be seen in the course of primary immunodeficiency diseases, and early functional and molecular genetic tests will aid the proper management.

Topics: Child; Eosinophilia; Guanine Nucleotide Exchange Factors; Humans; Hypersensitivity; Inappropriate ADH Syndrome; Infant; Job Syndrome; Vasopressins

A 78-year-old woman with a history of bronchial asthma presented with distal dominant sensory disturbance and weakness in the upper and lower extremities. A biopsy of the left peroneus brevis muscle showed active vasculitis with inflammation extending into muscle fascicles and fibrinoid necrosis of the vessel wall, consistent with eosinophilic granulomatosis with polyangiitis (EGPA). Despite her decreased serum osmolarity, her serum antidiuretic hormone level was not reduced, consistent with the syndrome of inappropriate antidiuretic hormone (SIADH). Intravenous and oral steroid therapy improved her neurological symptoms. Clinicians should consider EGPA as a concurrent, and potentially causative, disorder in cases of SIADH.

Topics: Adrenal Cortex Hormones; Aged; Eosinophilia; Female; Granulomatosis with Polyangiitis; Humans; Inappropriate ADH Syndrome; Vasopressins

Topics: Cataract; Child; Diabetes Insipidus; Diabetes Insipidus, Neurogenic; Diabetes Mellitus; Eosinophilia; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Toxoplasmosis; Toxoplasmosis, Congenital; Vasopressins