Friday, June 2, 2023
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Professor of Medicine
Division of Pulmonary, Critical Care, and Sleep Medicine
Director
Cohen Family Asthma Institute at National Jewish Health
National Jewish Health
Denver, Colorado
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This activity is intended for allergists, clinical immunologists, pulmonologists, and cardiologists.
The goal of this activity is to provide guided case studies with expert feedback to allow clinicians to improve their skills in assessing and treating patients with hypereosinophilic syndrome (HES).
Upon completion of this activity, participants will:
As an organization accredited by the ACCME, Medscape, LLC, requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.
Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.
Professor of Medicine
Division of Pulmonary, Critical Care, and Sleep Medicine
Director
Cohen Family Asthma Institute at National Jewish Health
National Jewish Health
Denver, Colorado
Medscape, LLC staff have disclosed that they have no relevant financial relationships.
This activity has been peer reviewed and the reviewer has disclosed no relevant financial relationships.
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The following cases are modeled on the interactive grand rounds approach. The questions within the activity are designed to test your current knowledge. After each question, you will be able to see whether you answered correctly and read evidence-based information that supports the most appropriate answer choice. The questions are designed to challenge you; you will not be penalized for answering the questions incorrectly. At the end of the activity, there will be a short post-test assessment based on the material presented.
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James is a 35-year-old engineer. Four years ago, he developed a rash that did not respond to topical steroids or oral antihistamines. Three years ago, he was diagnosed with asthma, which he manages with daily inhaled corticosteroids (ICS). He has been experiencing worsening pruritic skin lesions on his extremities, torso, and back of the neck for the past 3 months, which his primary care physician has said is probably eczema. He has also been experiencing increasing dyspnea upon exertion over the past month. He has a history of anxiety.
James presents to the emergency department with shortness of breath, wheezing, and worsening pruritic skin lesions. He has no fever, but he's slightly tachycardic and tachypneic, and his blood pressure is 145/86 mm Hg. He says he is tired all the time and complains about the stress of the pandemic and the effects it has had on the company where he works; he adds that his worsening rash and fatigue do not help matters. When asked about his current medications, James reports that he is taking daily ICS for asthma, along with daily oral corticosteroids for the rash and anti-anxiety medication. James also notes that he has tried to stop the oral corticosteroids because he does not like the way they make him feel. He has been experiencing mood swings and thinning hair, and he has been gaining weight. However, when he has tried to stop the corticosteroids, his rash worsens. His previous laboratory measures, which are in the system, show that he had an elevated eosinophil count, 11% of his white blood cell count, 3 years ago.
