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Respiratory Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Ian Pavord, Nayia Petousi, Nick Talbot
This is a very rare eosinophilic infiltration of many organs associated with arteritis. It usually presents with pyrexia, weight loss, abdominal pain and congestive cardiac failure resulting from myocardial involvement. Systemic corticosteroids shorten the duration of pulmonary eosinophilia and clear the pulmonary infiltrates. Hypereosinophilic syndrome is treated with oral corticosteroids and anti-IL-5 monoclonal antibodies.
Mucosal basophils, eosinophils, and mast cells
Published in Phillip D. Smith, Richard S. Blumberg, Thomas T. MacDonald, Principles of Mucosal Immunology, 2020
Edda Fiebiger, Stephan C. Bischoff
Finally, hypereosinophilic syndrome comprises a heterogeneous group of disorders characterized by excessive numbers of circulating and tissue-infiltrating eosinophils resulting in organ dysfunction. Some hypereosinophilic syndrome subtypes are myeloproliferative disorders, whereas the etiology of other variants remains undefined. Involvement of the gastrointestinal tract is common, and about 20% of patients experience diarrhea. Hypereosinophilic syndrome is a well-recognized cause of eosinophilic gastritis, gastroenteritis, and colitis, but in contrast to the other primary EGIDs, eosinophilic infiltration of other organs including the heart, skin, and nerves is characteristic. Consequently, hypereosinophilic syndrome might be considered to be a secondary EGID.
Answers
Published in Neel Sharma, Tiago Villanueva, Data Interpretation Made Easy, 2013
The history and investigations demonstrate evidence of hypereosinophilic syndrome associated with an eosinophil count greater than 1.5 × 109/L. Management relies on the use of steroids as the first line for those without the FIP1L1-PDGFRA genotype. Those with this genotype benefit from imatinib.
Clinical analysis of hypereosinophilic syndrome first presenting with asthma-like symptoms
Published in Annals of Medicine, 2022
Xuan Wei, Xiaofeng Li, Zuyou Wei, Hui Zhang, Jiehua Deng, Suke Xing, Jianquan Zhang
Hypereosinophilic syndrome (HES) is characterised by persistently elevated levels of eosinophils (EOS), their infiltration into various tissues and organs, and the emergence of corresponding clinical symptoms and signs; the clinical manifestations are complex and diverse. In 2011, the Working Conference on Eosinophil Disorders and Syndromes referred to any hypereosinophilia associated with organ damage as HES, clearly defining idiopathic hypereosinophilic syndrome (HESUS), primary hypereosinophilic syndrome (HESN), secondary hypereosinophilic syndrome (HESR), and other conditions and syndromes [1]. Because HESUS is diagnosed by exclusion, it is difficult to rapidly and effectively diagnose in a clinical setting. One of the most common causes of HESR is parasite infection, which is often ignored and may lead to multiple organ failure [2,3].
Dupilumab-induced hypereosinophilia: review of the literature and algorithm proposal for clinical management
Published in Expert Review of Respiratory Medicine, 2022
Marco Caminati, Bianca Olivieri, Annarita Dama, Claudio Micheletto, Pierluigi Paggiaro, Patrick Pinter, Gianenrico Senna, Michele Schiappoli
However, 1500 eosinophils/mmc is generally considered the threshold for close organ involvement monitoring and for further investigations; according to some authors, the same value has to be considered the cutoff for introducing specific treatments. For patients with milder forms of eosinophilia (AEC<1500/mmc) without symptoms or signs of organ involvement, a ‘watch and wait’ approach is suggested [50]. Besides the number of blood eosinophils, the persistence of hypereosinophilia over time should not be underestimated and requires in-depth diagnostic investigations in order to exclude organ damage or an underlying hematological cause. For this reason, the definition of hypereosinophilic syndrome has also been revised by reducing the duration of hypereosinophilia from six months to 1 month [51]. Organ damage should be assessed using lung function tests, chest radiography and/or computed tomography (CT) of the thorax, serum troponin T, and ecocardiography. The frequency and duration of monitoring organ damage and blood count during eosinophilia may vary depending on the individual case, the severity and extent of organ involvement, and/or worsening of the eosinophilia [35,46].
Eosinophilic pancreatitis presenting as possible malignancy
Published in Baylor University Medical Center Proceedings, 2021
Rebekah John, Theresa Yanchak, Jonathan Ramirez
EP is an allergic form of chronic pancreatitis that is difficult to distinguish from a pancreatic malignancy.3 EP is characterized by localized or diffuse eosinophilic infiltration of the pancreas and elevated serum IgE levels.3 Classically, diagnosis of EP is based on the presence of eosinophilic infiltration in tissue samples and meeting either hypereosinophilic syndrome or eosinophilic gastritis criteria. Diagnostic criteria for hypereosinophilic syndrome include a peripheral eosinophil count >1.5 × 109 for 6 months; a past medical history of rhinitis, asthma, or other allergic disease; eosinophilic infiltration of other organs; and exclusion of other causes for eosinophilia such as parasitic infestations or leukemia.4 Eosinophilic gastritis is diagnosed by the presence of abdominal pain, vomiting, nausea, diarrhea, or loss of appetite; intestinal sampling showing eosinophilic infiltration and ruling out parasitic infection; and no involvement of organs outside the gastrointestinal tract.