Rationale:Idiopathic hypereosinophilic syndrome (IHES) is a rare disease in which patients which present with eosinophilia-associated damage. Previous studies focused on organ damage from increased eosinophilic granulocytosis. We report IHES in a patient who presented with multiple organ damage (MOD).Patient concerns:A 52-year-old male presented with MOD, including myocardial damage suggestive of myocardial infarction, cardiac tamponade, respiratory failure, skin damage, and gastrointestinal damage.Diagnoses:The absolute eosinophil count was 12,920/mm3, much higher than occurs in other diseases associated with eosinophilia (1500/mm3), and suggesting a diagnosis of IHES.Interventions:Prednisone combined with hydroxyurea.Outcomes:At 6 months after completion of drug treatment, the patient had no chest pain or dyspnea, and the results of a blood panel, chest computed tomography, and gastroscopy were normal.Lessons:MOD is very rare in patients with IHES. Patients receiving prompt diagnosis and treatment have very good prognoses.

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