Loefflers syndrome laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
A complete blood count (CBC) with differential may show increased white blood cells, particularly eosinophils. In Loeffler syndrome eosinophilia is generally mild to moderate, usually 5-20%. On the other hand, in certain types of pulmonary eosinophilia, higher percentages are reported. For example, in drug-induced eosinophilia, eosinophils may account for as much as 40% of the WBCs. Generally, the result of stool examination is negative at the time of the Loeffler syndrome presentation. Nevertheless, parasites and ova can be found in the stool 6-12 weeks after the initial parasitic infection. Pulmonary symptoms usually have been resolved when parasitic forms are found in the stool. Immunoglobulin E (IgE) level might be elevated. A bronchoscopy with bronchoalveolar lavage may show increased eosinophilic count. Sputum analysis or gastric lavage may occasionally show | A [[complete blood count]] (CBC) with differential may show increased [[white blood cells]], particularly [[Eosinophil granulocyte|eosinophils]]. In Loeffler syndrome [[eosinophilia]] is generally mild to moderate, usually 5-20%. On the other hand, in certain types of pulmonary [[eosinophilia]], higher percentages are reported. For example, in [[Eosinophilia causes|drug-induced eosinophilia]], eosinophils may account for as much as 40% of the WBCs. Generally, the result of stool examination is negative at the time of the Loeffler syndrome presentation. Nevertheless, parasites and ova can be found in the stool 6-12 weeks after the initial [[Human parasitic diseases|parasitic infection]]. [[Lung|Pulmonary]] symptoms usually have been resolved when parasitic forms are found in the stool. [[Immunoglobulin E]] (IgE) level might be elevated. A [[bronchoscopy]] with [[bronchoalveolar lavage]] may show increased eosinophilic count. [[Sputum|Sputum analysis]] or [[gastric lavage]] may occasionally show larvae of [[Ascaris lumbricoides|Ascaris]] or the other parasites with pulmonary cycle. | ||
==Laboratory Findings== | ==Laboratory Findings== | ||
Laboratory findings consistent with the diagnosis of Loeffler syndrome include:<ref name="pmid21062596">Te Booij M, de Jong E, Bovenschen HJ (2010) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=21062596 Löffler syndrome caused by extensive cutaneous larva migrans: a case report and review of the literature.] ''Dermatol Online J'' 16 (10):2. PMID: [https://pubmed.gov/21062596 21062596]</ref><ref name="pmid16612768">Chitkara RK, Krishna G (2006) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16612768 Parasitic pulmonary eosinophilia.] ''Semin Respir Crit Care Med'' 27 (2):171-84. [http://dx.doi.org/10.1055/s-2006-939520 DOI:10.1055/s-2006-939520] PMID: [https://pubmed.gov/16612768 16612768]</ref><ref name="pmid21062596">Te Booij M, de Jong E, Bovenschen HJ (2010) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=21062596 Löffler syndrome caused by extensive cutaneous larva migrans: a case report and review of the literature.] ''Dermatol Online J'' 16 (10):2. PMID: [https://pubmed.gov/21062596 21062596]</ref><ref name="pmid24931460">Ekin S, Sertogullarindan B, Gunbatar H, Arisoy A, Yildiz H (2016) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=24931460 Loeffler's syndrome: an interesting case report.] ''Clin Respir J'' 10 (1):112-4. [http://dx.doi.org/10.1111/crj.12173 DOI:10.1111/crj.12173] PMID: [https://pubmed.gov/24931460 24931460]</ref> <ref name="pmid13480465">Caulet T (1957) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=13480465 [Loffler syndrome and pulmonary eosinophilia].] ''Gaz Med Fr'' 64 (20):1737-8 passim. PMID: [https://pubmed.gov/13480465 13480465]</ref><ref name="pmid5667987"> (1968) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=5667987 Löffler's syndrome.] ''Br Med J'' 3 (5618):569-70. PMID: [https://pubmed.gov/5667987 5667987]</ref><ref name="pmid21007279">SASLAW MS, BOWMAN JA (1946) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=21007279 Loeffler's syndrome.] ''J Fla Med Assoc'' 32 ():373. PMID: [https://pubmed.gov/21007279 21007279]</ref><ref name="pmid21025484">SPECTOR HI (1945) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=21025484 Loeffler's syndrome (transient pulmonary infiltrations with eosinophilia); report of a case and a review of the available literature.] ''Dis Chest'' 11 ():380-91. PMID: [https://pubmed.gov/21025484 21025484]</ref><ref name="pmid21010826">GREIG ED (1945) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=21010826 On tropical eosinophilia associated with pulmonary signs (Loeffler's syndrome).] ''J Trop Med Hyg'' 48 ():149-51. PMID: [https://pubmed.gov/21010826 21010826]</ref> | Laboratory findings consistent with the diagnosis of Loeffler syndrome include:<ref name="pmid21062596">Te Booij M, de Jong E, Bovenschen HJ (2010) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=21062596 Löffler syndrome caused by extensive cutaneous larva migrans: a case report and review of the literature.] ''Dermatol Online J'' 16 (10):2. PMID: [https://pubmed.gov/21062596 21062596]</ref><ref name="pmid16612768">Chitkara RK, Krishna G (2006) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16612768 Parasitic pulmonary eosinophilia.] ''Semin Respir Crit Care Med'' 27 (2):171-84. [http://dx.doi.org/10.1055/s-2006-939520 DOI:10.1055/s-2006-939520] PMID: [https://pubmed.gov/16612768 16612768]</ref><ref name="pmid21062596">Te Booij M, de Jong E, Bovenschen HJ (2010) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=21062596 Löffler syndrome caused by extensive cutaneous larva migrans: a case report and review of the literature.] ''Dermatol Online J'' 16 (10):2. PMID: [https://pubmed.gov/21062596 21062596]</ref><ref name="pmid24931460">Ekin S, Sertogullarindan B, Gunbatar H, Arisoy A, Yildiz H (2016) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=24931460 Loeffler's syndrome: an interesting case report.] ''Clin Respir J'' 10 (1):112-4. [http://dx.doi.org/10.1111/crj.12173 DOI:10.1111/crj.12173] PMID: [https://pubmed.gov/24931460 24931460]</ref> <ref name="pmid13480465">Caulet T (1957) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=13480465 [Loffler syndrome and pulmonary eosinophilia].] ''Gaz Med Fr'' 64 (20):1737-8 passim. PMID: [https://pubmed.gov/13480465 13480465]</ref><ref name="pmid5667987">(1968) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=5667987 Löffler's syndrome.] ''Br Med J'' 3 (5618):569-70. PMID: [https://pubmed.gov/5667987 5667987]</ref><ref name="pmid21007279">SASLAW MS, BOWMAN JA (1946) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=21007279 Loeffler's syndrome.] ''J Fla Med Assoc'' 32 ():373. PMID: [https://pubmed.gov/21007279 21007279]</ref><ref name="pmid21025484">SPECTOR HI (1945) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=21025484 Loeffler's syndrome (transient pulmonary infiltrations with eosinophilia); report of a case and a review of the available literature.] ''Dis Chest'' 11 ():380-91. PMID: [https://pubmed.gov/21025484 21025484]</ref><ref name="pmid21010826">GREIG ED (1945) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=21010826 On tropical eosinophilia associated with pulmonary signs (Loeffler's syndrome).] ''J Trop Med Hyg'' 48 ():149-51. PMID: [https://pubmed.gov/21010826 21010826]</ref> | ||
* '''CBC diff''' | * '''CBC diff''' | ||
:* A complete blood count (CBC) with differential may show increased white blood cells, particularly eosinophils. | :* A complete blood count (CBC) with differential may show increased white blood cells, particularly eosinophils. | ||
Latest revision as of 14:32, 11 June 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]
Overview
A complete blood count (CBC) with differential may show increased white blood cells, particularly eosinophils. In Loeffler syndrome eosinophilia is generally mild to moderate, usually 5-20%. On the other hand, in certain types of pulmonary eosinophilia, higher percentages are reported. For example, in drug-induced eosinophilia, eosinophils may account for as much as 40% of the WBCs. Generally, the result of stool examination is negative at the time of the Loeffler syndrome presentation. Nevertheless, parasites and ova can be found in the stool 6-12 weeks after the initial parasitic infection. Pulmonary symptoms usually have been resolved when parasitic forms are found in the stool. Immunoglobulin E (IgE) level might be elevated. A bronchoscopy with bronchoalveolar lavage may show increased eosinophilic count. Sputum analysis or gastric lavage may occasionally show larvae of Ascaris or the other parasites with pulmonary cycle.
Laboratory Findings
Laboratory findings consistent with the diagnosis of Loeffler syndrome include:[1][2][1][3] [4][5][6][7][8]
- CBC diff
- A complete blood count (CBC) with differential may show increased white blood cells, particularly eosinophils.
- In Loeffler syndrome eosinophilia is generally mild to moderate, usually 5-20%.
- On the other hand, in certain types of pulmonary eosinophilia, higher percentages are reported.
- For example, in drug-induced eosinophilia, eosinophils may account for as much as 40% of the WBCs.
- Stool exam
- Generally the result of stool examination is negative at the time of the Loeffler syndrome presentation.
- Nevertheless, parasites and ova can be found in the stool 6-12 weeks after the initial parasitic infection.
- Pulmonary symptoms usually have been resolved when parasitic forms are found in the stool.
- Immunoglobulin E (IgE) level
- Might be elevated.
- Bronchoscopy and bronchoalveolar lavage
- A bronchoscopy with bronchoalveolar lavage may show increased eosinophilic count.
- Sputum analysis or gastric lavage
- Sputum analysis or gastric lavage may occasionally show Larvae of Ascaris or the other parasites with pulmonary cycle.
Follow-up
- 4-6 weeks after the initial presentation: Repeat CBC count (document resolution of eosinophilia).
- 6-12 weeks after initial presentation: Examine stool for ova and parasites.
References
- ↑ 1.0 1.1 Te Booij M, de Jong E, Bovenschen HJ (2010) Löffler syndrome caused by extensive cutaneous larva migrans: a case report and review of the literature. Dermatol Online J 16 (10):2. PMID: 21062596
- ↑ Chitkara RK, Krishna G (2006) Parasitic pulmonary eosinophilia. Semin Respir Crit Care Med 27 (2):171-84. DOI:10.1055/s-2006-939520 PMID: 16612768
- ↑ Ekin S, Sertogullarindan B, Gunbatar H, Arisoy A, Yildiz H (2016) Loeffler's syndrome: an interesting case report. Clin Respir J 10 (1):112-4. DOI:10.1111/crj.12173 PMID: 24931460
- ↑ Caulet T (1957) [Loffler syndrome and pulmonary eosinophilia.] Gaz Med Fr 64 (20):1737-8 passim. PMID: 13480465
- ↑ (1968) Löffler's syndrome. Br Med J 3 (5618):569-70. PMID: 5667987
- ↑ SASLAW MS, BOWMAN JA (1946) Loeffler's syndrome. J Fla Med Assoc 32 ():373. PMID: 21007279
- ↑ SPECTOR HI (1945) Loeffler's syndrome (transient pulmonary infiltrations with eosinophilia); report of a case and a review of the available literature. Dis Chest 11 ():380-91. PMID: 21025484
- ↑ GREIG ED (1945) On tropical eosinophilia associated with pulmonary signs (Loeffler's syndrome). J Trop Med Hyg 48 ():149-51. PMID: 21010826