Past medical conditions included chronic eosinophilic pneumonia (CEP) and chronic medication included a monthly administration of 100mg intravenous mepolizumab. She denied smoking or alcohol intake. No family history of pancreatic cancer or chronic pancreatitis was mentioned.On abdominal magnetic resonance, the same hypoattenuating lesion with delayed enhacement was detected, as well as other small lesions with similar features in the pancreatic body and tail. Endoscopic ultrassound (EUS) was then performed, revealing four hypoechoic round-shaped lesions, with no signs of invasion of adjacent structures, local adenopathies nor hepatobiliary ductal alterations. EUS-fine needle aspiration was performed in the larger lesion, revealing only generalized fibrosis. Given the abovementioned clinical description, a clinical diagnosis of eosinophilic pancreatitis (EP) was made. After multidisciplinary discussion, a strategy of clinical and imagiological surveillance was adopted. DiscussionEP is an extremely rare condition, characterized by infiltration of the pancreas with eosinophils. This case of EP is not as linear as other case reports found on the literature, given that the patient was under anti-IL-5 monoclonal antibody therapy, which lowers the eosinophilic count. However, the previous diagnosis of CEP prompted the clinicians to hypothesize a condition of eosinophilic infiltration in this setting. Given that long-standing eosinophilic inflammation induces remodelling and fibrosis of the affected tissues, the finding of generalized fibrosis in this setting is not surprising. Clinical follow-up will be extremely important due to the possibility of developing chronic pancreatitis in the long-term.