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Case Reports in Rheumatology
Volume 2012, Article ID 934324, 3 pages
Case Report

Severe Eosinophilic Syndrome Associated with the Use of Probiotic Supplements: A New Entity?

1Jefferson Institute of Molecular Medicine and Scleroderma Center, Thomas Jefferson University, Philadelphia, PA 19107, USA
2Rheumatology Division, Department of Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA
3Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson University, Philadelphia, PA 19107, USA

Received 12 October 2012; Accepted 4 November 2012

Academic Editors: K. P. Makaritsis, S. C. Plastiras, and P. E. Prete

Copyright © 2012 Fabian A. Mendoza et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Severe eosinophilic syndromes related to the administration or use of unsuspected immunogenic substances have been described previously. Many of these diseases presented initially as clusters or isolated cases. The spanish toxic oil syndrome, the eosinophilia myalgia syndrome, and nephrogenic systemic fibrosis are examples of such diseases. We describe 2 cases of a severe eosinophilic syndrome characterized by marked peripheral blood eosinophilia (>15,000 cells/ml), mononeuritis multiplex, and necrotizing vasculitis which developed in a close temporal association with the recent onset use of nonprescription probiotics. There was no history of a prior autoimmune disease. Although both cases had prompt response to immunosuppression with rapid resolution of peripheral blood eosinophilia and accompanying constitutional symptoms, they remained with permanent neurological deficits.