Loefflers syndrome laboratory findings
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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