A 26-year-old woman was diagnosed as having autoimmune hemolytic anemia in September 2002. Her eosinophil count was already high (2,190/microliter) at that time. She received prednisolone therapy with a good response and was released from the treatment in April 2003. Eosinophil numbers were within the normal range under the prednisolone administration. However, they began to increase after its completion. No underlying causes for the eosinophilia were evident. When the eosinophil count reached 5,474/microliter, the patient developed massive pleural effusion as well as palpebral swelling and myalgia, leading to a diagnosis of hypereosinophilic syndrome. Re-administration of prednisolone resulted in the disappearance of these symptoms and eosinophilia. Her eosinophils seemed to have reactivated after cessation of the prednisolone therapy and infiltrated into her organs.
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