Differential diagnosis of eosinophilia
Authors:
Z. Adam; M. Tomíška; M. Krejčí; L. Pour
Authors‘ workplace:
Interní hematoonkologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Jiří Vorlíček, CSc.
Published in:
Vnitř Lék 2009; 55(Suppl 1)(Supplementum 1): 125-144
Overview
Elevated eosinophil count might be a sign of many different pathologies. Most frequently, this is a result of allergic conditions. Elevated eosinophil count associated with a parasitic infection is considered as physiological. Eosinophilia may be linked to certain organ and connective tissue disorders. The primary increase in eosinophil count may be caused by pathologic (benign or malignant) cloning of T-lymphocytes that, through their cytokines, stimulate proliferation and differentiation of eosinophilic lineage. Nonetheless, the primary malfunction could also be directly in the myeloid cell line. Some of the myeloid cell mutations associated with uncontrolled eosinophilic myeloproliferation have been described, others are awaiting identification. The aim of this paper is to describe all states that result in elevated peripheral blood eosinophil count and provide directions for differential diagnosis.
Key words:
eosinophilia – hypereosinophilic syndrome – eosinophilic leukaemia
Sources
1. Adam Z, Elbl L, Bulíková A et al. Eozinofilie, idiopatický hypereozinofilní syndrom/chronická eozinofilní leukémie. Postgrad Med 2003; 5: 471–487.
2. Bain BJ, Fletcher SH. Chronic eosinophilic leukemias and the myeloproliferative variant of the hypereosinophilic syndrome. Immunol Allergy Clin North Am 2007; 27: 377–388.
3. Bohm M, Richter JE. Treatment of eosinophilic esophagitis: overview, current limitations, and future direction. Am J Gastroenterol 2008; 103: 2635–2644.
4. Capovilla M, Cayuela JM, Bilhou-Nabera Cet al. Synchronous FIP1L1-PDGFRA-positive chronic eosinophilic leukemia and T-cell lymphoblastic lymphoma: a bilineal clonal malignancy. Eur J Haematol 2008; 80: 81–86.
5. Carnero‑Alcázar M, Reguillo-Lacruz F,O’Connor F et al. Hypereosinophilic syndrome and myocardial fibrosis. Interact Cardiovasc Thorac Surg 2008; 7: 928–930.
6. Cilloni D, Messa F, Martinelli G et al. WT1 transcript amount discriminates secondary or reactive eosinophilia from idiopathic hypereosinophilic syndrome or chronic eosinophilic leukemia. Leukemia 2007; 21: 1442–1450.
7. Corradi D, Maestri R, Facchetti F. Postpartum Churg‑Strauss syndrome with severe cardiac involvement: Description of a case and review of the literature. Clin Rheumatol 2009. V tisku.
8. D’Angelo G, Hotz AM, Todeschin P. Acute lymphoblastic leukemia with hypereosinophilia and 9p21 deletion: case report and review of the literature. Lab Hematol 2008; 14: 7–9.
9. do Prado AD, de Figueiredo CE, Marrone CD et al. Episcleris, arthrofasciitis and hypereosinophilia: primary hypereosinophilic syndrome or atypical Wegener’s granulomatosis? Rheumatol Int 2007; 28: 89–90.
10. Duval A, Bergoin E, Maynadié M et al. Images in haematology. Hypereosinophilia as a presenting feature of anaplastic large cell lymphoma. Br J Haematol 2008; 140: 363.
11. Estrada-Reyes E, Hernnández-Román MP, Gamboa-Marrufo JD et al. Hypereosinophilia, hyper‑IgE syndrome, and atopic dermatitis in a toddler with food hypersensitivity. J Investig Allergol Clin Immunol 2008; 18: 131–135.
12. Garcia-Alvarez A, Sitges M, Garcia-Albeniz X et al. Atypical cardiac manifestation of hypereosinophilic syndrome and reversible cardiotoxicity to imatinib. Int J Cardiol 2008. V tisku.
13. González Delgado P, de la Sen Fernández ML, Soriano Gomis V et al. Cyclical hypereosinophilia with skin manifestations and a clonal T cell population. J Investig Allergol Clin Immunol 2008; 18: 401–403.
14. Gotlib J, Cools J. Five years since the discovery of FIP1L1-PDGFRA: what we have learned about the fusion and other molecularly defined eosinophilias. Leukemia 2008; 22: 1999–2010.
15. Haghpanah V, Lashkari A, Tavangar SM et al. Hypereosinophilia as the presentation of metastatic medullary thyroid carcinoma: a remarkable event. Am J Med Sci 2000; 334: 131–132.
16. Helbig G, Stella-Hołowiecka B, Majewski M et al. A single weekly dose of imatinib is sufficient to induce and maintain remission of chronic eosinophilic leukaemia in FIP1L1-PDGFRA-expressing patients. Br J Haematol 2008; 141: 200–204.
17. Husár R, Václavík J, Lukl J. Newly diagnosed Churga-Strauss syndrome in a female patient with suspect acute coronary syndrome. Vnitř Lék 2008; 54: 1102–1105.
18. Chrobák L, Voglová J. Idiopatický hypereozinofilní syndrom a chronická eozinofilní leukemie. Vnitř Lék 2005; 51: 1385–1393.
19. Iwata H, Tsuboi N, Ishii T et al. Hypereosinophilia associated with increased serum levels of carcinoembryonic antigen. Intern Med 2008; 47: 963–967.
20. Kahn JE, Blétry O, Guillevin L. Hypereosinophilic syndromes. Best Pract Res Clin Rheumatol 2008; 22: 863–882.
21. Kalac M, Quintás-Cardama A, Vrhovac R et al. A critical appraisal of conventional and investigational drug therapy in patients with hypereosinophilic syndrome and clonal eosinophilia. Cancer 2007; 110: 955–964.
22. Lee JH, Park HK, Heo J et al. Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome induced by celecoxib and anti‑tuberculosis drugs. J Korean Med Sci 2008; 23: 521–525.
23. Macků M, Rybníček P, Tomanová Y et al. Eosinofilie – nesnadný hlavolam. Pediatr pro Prax 2005; 6: 35–37.
24. Nakagome K, Dohi M, Okunishi K et al. IL‑5‑induced hypereosinophilia suppresses the antigen‑induced immune response via a TGF‑beta‑dependent mechanism. J Immunol 2007; 179: 284–294.
25. Nathan N, Guillemot N, Aubertin G et al. Chronic eosinophilic pneumonia in a 13-year-old child. Eur J Pediatr 2008; 167: 1203–1207.
26. Oberholzer C, Nüesch R, Häusermann P. Urticaria and parasites: case report and general view over the most common pathogens of chronic urticaria. Praxis (Bern 1994) 2007; 96: 865–870.
27. Quintás-Cardama A, Cortes J. Therapeutic options for patients with clonal and idiopathic hypereosinophia. Expert Opin Investig Drugs 2008; 17: 1039–1050.
28. Roufosse F, Cogan E, Goldman M. Lymphocytic variant hypereosinophilic syndromes. Immunol Allergy Clin North Am 2007; 27: 389–413.
29. Roufosse FE, Goldman M, Cogan E. Hypereosinophilic syndromes. Orphanet J Rare Dis 2007; 2: 37.
30. Sade K, Mysels A, Levo Y et al. Eosinophilia: A study of 100 hospitalized patients. Eur J Intern Med 2007; 18: 196–201.
31. Sheikh J, Weller PF. Advances in diagnosis and treatment of eosinophilia. Curr Opin Hematol 2009; 16: 3–8.
32. Sheikh J, Weller PF. Clinical overview of hypereosinophilic syndromes. Immunol Allergy Clin North Am 2007; 27: 333–355.
33. Sun CY, Hu Y, Chu ZB et al. Successful treatment of myeloid neoplasms associated with PDGFRA rearrangement with imatinib mesylate. Int J Hematol 2009; 89: 66–70.
34. Šteruská M, Demečková E, Benžová M et al. Hypereozinofilný syndróm – leukemia, lymfómy, myeloproliferatívny a myelodysplastický syndróm s eozinofíliou. Hemat Transfuz 1994; 4: 14–22.
35. Vaida I, Roszkiewicz F, Gruson B et al. Drug rash with eosinophilia and systemic symptoms after chlorambucil treatment in chronic lymphocytic leukaemia. Pharmacology 2009; 83: 148–149.
36. Zavřelová A, Žák P. BCR/ABL negativní myeloproliferativní onemocnění s eozinofilií. Lék Zprav 2006; 51: 197–198.
37. Tefferi A. Eosinophilia: secondary, clonal and idiopatic. Brit J Hematol 2006; 133: 468–492.
38. Brigden ML. A practical workup for eosinophilia. Postgraduate Med 1999; 105: 193–211.
39. Vaillant L. Drug hypersensitivity syndrome: drug rash, with eosinophilia and systemic symptoms – DRESS. J Dermatol Treatment 1999; 10: 267–272.
40. Cottin V. Churg‑Strauss syndrome. J Allergy 1999; 54: 535–551.
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Diabetology Endocrinology Internal medicineArticle was published in
Internal Medicine
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