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__NOTOC__ | __NOTOC__ | ||
{{Eosinophilia}} | {{Eosinophilia}} | ||
{{CMG}} {{AE}} | {{CMG}} {{AE}}George Leef MD | ||
==Overview== | ==Overview== | ||
Eosinophilia refers to elevated eosinophils in the peripheral blood. It is important to remember that eosinophilia is a ''symptom'', not a disease. Eosinophilia can be a manifestation of a variety of different disease processes, including neoplastic, infectious, allergic, and idiopathic processes. | |||
==Historical Perspective== | ==Historical Perspective== | ||
* | *As mentioned above, eosinophilia is not a unified disease entity, but rather a manifestation of many different disease processes. | ||
* | *The [[eosinophil]] itself was discovered in 1879 <ref>Kay AB. The early history of the eosinophil. Clin Exp Allergy. 2015 Mar;45(3):575-82.</ref> as a granulocytic cell that stained with the red dye eosin. [[Granulocyte|Granulocytes]] in general were described several decades earlier. | ||
==Classification== | ==Classification== | ||
*[ | *Major disease categories that can cause eosinophilia: | ||
*Allergy/Atopy | |||
*Infections | |||
**Parasitic | |||
* | **Certain fungal organisms (Coccidiomycosis, Aspergillus) | ||
*Malignancies | |||
**Hematologic (primary eosinophil neoplasia, B and T cell [[Lymphoma|lymphomas]], [[Chronic myelogenous leukemia|CML]]) | |||
**Solid tumors (esp GI malignancies) | |||
*[[Addison's disease|Addison's Disease]] | |||
*Drug Reactions ([[DRESS syndrome|DRESS]]) | |||
*Vasculitis ([[Churg-Strauss syndrome|Churg-Strauss]]) | |||
*Idiopathic | |||
==Pathophysiology== | ==Pathophysiology== | ||
* | *Eosinophilia is defined by blood eosinophil count > 500/microL. | ||
*The | *The pathogenesis is variable. Eosinophila can be caused by a proliferative neoplasm (as in CML), or as a reaction to another process (parasitic infection, drug reaction, solid tumor). | ||
==Causes== | ==Causes== | ||
* | * | ||
==Differentiating eosinophilia from other Diseases== | |||
*If the eosinophil count is elevated, eosinophilia is present by definition. Care should be taken to discover the correct cause for the eosinophilia. | |||
==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
* The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide. | * The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide. | ||
| Line 40: | Line 37: | ||
===Age=== | ===Age=== | ||
*Patients of all age groups may develop | *Patients of all age groups may develop eosinophilia, although the likely cause of eosinophilia is different depending on age. | ||
*[Disease name] is more commonly observed among patients aged [age range] years old. | *[Disease name] is more commonly observed among patients aged [age range] years old. | ||
| Line 58: | Line 55: | ||
==Risk Factors== | ==Risk Factors== | ||
*Common risk factors in the development of | *Common risk factors in the development of eosinophilia are allergies and parasitic infections. Eosinophilia is most commonly associated with allergic processes in developed countries and with parasitic infections in developing countries. | ||
== Natural History, Complications and Prognosis== | == Natural History, Complications and Prognosis== | ||
* | *Highly variable based on the underlying etiology. | ||
* | *The diseases eosinophilia can be associated with have a wide range of natural histories and prognoses. | ||
*An asthmatic patient with eosinophilia has a very different prognosis than a cancer patient with eosinophilia | |||
* | |||
== Diagnosis == | == Diagnosis == | ||
===Diagnostic Criteria=== | ===Diagnostic Criteria=== | ||
*The diagnosis of | *The diagnosis of eosinophilia is made when the peripheral blood eosinophil count is greater than 500 cells/microL. | ||
=== Symptoms === | === Symptoms === | ||
*Symptoms of eosinophilia are highly variable and reflect the underlying disease. | |||
*Symptoms of | |||
=== Physical Examination === | === Physical Examination === | ||
* | * Physical exam findings in eosinophilia are highly variable and reflect the underlying disease. | ||
=== Laboratory Findings === | === Laboratory Findings === | ||
*There are no specific laboratory findings associated with | *There are no specific laboratory findings associated with eosinophilia aside from the elvated eosinophil count. | ||
===Imaging Findings=== | ===Imaging Findings=== | ||
*There are no | *There are no imaging findings associated with eosinophilia unless it is secondary to a disease process that causes imaging findings. | ||
== Treatment == | == Treatment == | ||
=== Medical Therapy === | === Medical Therapy === | ||
* | *Medical treatment for eosinophilia should be directed at the underlying cause (ie treating parasitic infection). | ||
*In primary eosinophilias, corticosteroids can be used for immune suppression. | |||
* | |||
=== Surgery === | === Surgery === | ||
*Surgery | *Surgery may be part of the treatment for certain causes of eosinophilia, such as solid organ malignancies. However most conditions associated with eosinophilia are not treated surgically. | ||
=== Prevention === | === Prevention === | ||
*There are no primary preventive measures available for | *There are no primary preventive measures available for eosinophilia. | ||
* | *Primary prevention should be targeted as specific disease entities. | ||
==References== | ==References== | ||
Revision as of 05:26, 19 June 2016
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Eosinophilia Microchapters |
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Eosinophilia overview On the Web |
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American Roentgen Ray Society Images of Eosinophilia overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: George Leef MD
Overview
Eosinophilia refers to elevated eosinophils in the peripheral blood. It is important to remember that eosinophilia is a symptom, not a disease. Eosinophilia can be a manifestation of a variety of different disease processes, including neoplastic, infectious, allergic, and idiopathic processes.
Historical Perspective
- As mentioned above, eosinophilia is not a unified disease entity, but rather a manifestation of many different disease processes.
- The eosinophil itself was discovered in 1879 [1] as a granulocytic cell that stained with the red dye eosin. Granulocytes in general were described several decades earlier.
Classification
- Major disease categories that can cause eosinophilia:
- Allergy/Atopy
- Infections
- Parasitic
- Certain fungal organisms (Coccidiomycosis, Aspergillus)
- Malignancies
- Addison's Disease
- Drug Reactions (DRESS)
- Vasculitis (Churg-Strauss)
- Idiopathic
Pathophysiology
- Eosinophilia is defined by blood eosinophil count > 500/microL.
- The pathogenesis is variable. Eosinophila can be caused by a proliferative neoplasm (as in CML), or as a reaction to another process (parasitic infection, drug reaction, solid tumor).
Causes
Differentiating eosinophilia from other Diseases
- If the eosinophil count is elevated, eosinophilia is present by definition. Care should be taken to discover the correct cause for the eosinophilia.
Epidemiology and Demographics
- The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide.
- In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].
Age
- Patients of all age groups may develop eosinophilia, although the likely cause of eosinophilia is different depending on age.
- [Disease name] is more commonly observed among patients aged [age range] years old.
- [Disease name] is more commonly observed among [elderly patients/young patients/children].
Gender
- [Disease name] affects men and women equally.
- [Gender 1] are more commonly affected with [disease name] than [gender 2].
- The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.
Race
- There is no racial predilection for [disease name].
- [Disease name] usually affects individuals of the [race 1] race.
- [Race 2] individuals are less likely to develop [disease name].
Risk Factors
- Common risk factors in the development of eosinophilia are allergies and parasitic infections. Eosinophilia is most commonly associated with allergic processes in developed countries and with parasitic infections in developing countries.
Natural History, Complications and Prognosis
- Highly variable based on the underlying etiology.
- The diseases eosinophilia can be associated with have a wide range of natural histories and prognoses.
- An asthmatic patient with eosinophilia has a very different prognosis than a cancer patient with eosinophilia
Diagnosis
Diagnostic Criteria
- The diagnosis of eosinophilia is made when the peripheral blood eosinophil count is greater than 500 cells/microL.
Symptoms
- Symptoms of eosinophilia are highly variable and reflect the underlying disease.
Physical Examination
- Physical exam findings in eosinophilia are highly variable and reflect the underlying disease.
Laboratory Findings
- There are no specific laboratory findings associated with eosinophilia aside from the elvated eosinophil count.
Imaging Findings
- There are no imaging findings associated with eosinophilia unless it is secondary to a disease process that causes imaging findings.
Treatment
Medical Therapy
- Medical treatment for eosinophilia should be directed at the underlying cause (ie treating parasitic infection).
- In primary eosinophilias, corticosteroids can be used for immune suppression.
Surgery
- Surgery may be part of the treatment for certain causes of eosinophilia, such as solid organ malignancies. However most conditions associated with eosinophilia are not treated surgically.
Prevention
- There are no primary preventive measures available for eosinophilia.
- Primary prevention should be targeted as specific disease entities.
References
- ↑ Kay AB. The early history of the eosinophil. Clin Exp Allergy. 2015 Mar;45(3):575-82.