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🌱 來自: Huppert’s Notes

Peripheral Eosinophilia and Hypereosinophilia Syndromes🚧 施工中

Peripheral Eosinophilia and Hypereosinophilia Syndromes

•   Definition

-   Eosinophilia: Absolute eosinophil count >500/μl (500–1500/μl more likely due to atopic disease)

-   Hypereosinophilia: Severe eosinophilia >1500/μl; worry especially if >5000/μl since risk of end organ damage increases (e.g., eosinophilic dermatitis, myocarditis, hepatitis)

•   Etiologies:

-   Neoplasms:

   Monoclonal: Primary hypereosinophilic syndrome (can check for mutations like PDGFRB, PDGFRA, FGFR-1, AEL, and CEL, which cause a monoclonal eosinophil proliferation)

   Polyclonal: T-cell lymphoma, Hodgkin’s lymphoma, some solid organ malignancies cause reactive eosinophilia (e.g., cervical cancer, ovarian cancer, SCC, gastric and colon cancer, urothelial cancer)

-   Allergies, which includes asthma and drug-induced eosinophilia (including DRESS)

-   Adrenal insufficiency

-   Connective tissue diseases: Eosinophilic granulomatosis with polyangiitis (eGPA) and rheumatoid arthritis

-   Parasites

   Lymphatic filiariasis, toxocara, trichinosis and strongyloides can all cause an eosinophil count >5000/μl. Only multicellular parasites cause eosinophilia.

   Other infections may also cause lower degrees of eosinophilia (e.g., ABPA, cocci, HIV)

-   Organ-restricted hypereosinophilic conditions (e.g., eosinophilic fasciitis, eosinophilic cellulitis, etc.) can cause peripheral eosinophilia