Allergy Asthma Respir Dis.  2019 Jul;7(3):142-149. 10.4168/aard.2019.7.3.142.

Etiologies and differential markers of eosinophilia-associated diseases in the Allergy Department of a single university hospital

• Yu JE
• Sim DW
• Koh YI

• KMID: 2461407
• DOI: http://doi.org/10.4168/aard.2019.7.3.142

Abstract

PURPOSE
We aimed to analyze the frequency of eosinophilia-associated diseases and to search for possible markers that may be useful for their differential diagnosis.
METHODS
We retrospectively reviewed the medical records of 148 patients with peripheral blood eosinophil count of more than 500/µL who visited the Allergy Department of Chonnam National University Hospital for the first time from January to December 2016. Blood eosinophilia was categorized as mild (<1,500/µL), moderate (1,500-5,000/µL), and severe (>5,000/µL).
RESULTS
Blood eosinophilia was mostly caused by allergic diseases (41.9%), parasitic infestation (23.6%), and drug allergy (19.6%). Eosinophil count was higher in patients with parasitic infestation (P<0.01), drug allergy (P<0.01), hypereosinophilic syndrome (HES, P<0.001), or eosinophilic granulomatosis with polyangiitis (EGPA, P<0.001) than in those with allergic diseases. The eosinophilic cationic protein level was higher in patients with HES than in those with allergic diseases (P<0.05) and parasitic infestation (P<0.05). The total IgE level was lower in patients with HES than in those with parasitic infestation (P<0.05) and EGPA (P<0.05). The vitamin B12 level was higher in patients with HES than in those with parasitic infestation (P<0.05). There was no statistically significant difference in tryptase levels between the groups. The most common cause of mild eosinophilia was allergic diseases (59.8%), followed by parasitic infestation (22.7%) and drug allergy (13.4%). The common causes of moderate eosinophilia were drug allergy (37.8%), parasitic infestation (29.7%), and allergic diseases (10.8%). The common causes of severe eosinophilia were EGPA (28.6%), HES (21.4%), parasitic infestation (14.3%), and drug allergy (14.3%).
CONCLUSION
Common causes of blood eosinophilia in patients who visit the allergy department are allergic diseases, parasitic infestation, and drug allergy. Several markers, including eosinophil count, total IgE, and vitamin B12, may be useful for the differential diagnosis of eosinophilia-associated diseases.

Keyword

Eosinophilia; Immunoglobulin E; Vitamin B₁₂

MeSH Terms

Diagnosis, Differential
Drug Hypersensitivity
Eosinophilia
Eosinophils
Granulomatosis with Polyangiitis
Humans
Hypereosinophilic Syndrome
Hypersensitivity*
Immunoglobulin E
Jeollanam-do
Medical Records
Parasitic Diseases
Retrospective Studies
Tryptases
Vitamin B 12
Immunoglobulin E
Tryptases
Vitamin B 12

Figure

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  Fig. 1. Frequency of eosinophilia-associated diseases in all patients (n=148). ABPA, allergic bronchopulmonary aspergillosis; CEP, chronic eosinophilic pneumonia; EGID, eosinophilic gastrointestinal disorder; EGPA, eosinophilic granulomatosis with polyangiitis; HES, hypereosinophilic syndrome.

• 

  Fig. 2. Frequency of eosinophilia-associated diseases in patients with mild (A), moderate (B), and severe (C) eosinophilia. ABPA, allergic bronchopulmonary aspergillosis; CEP, chronic eosinophilic pneumonia; EGID, eosinophilic gastrointestinal disorder; EGPA, eosinophilic granulomatosis with polyangiitis; HES, hypereosinophilic syndrome.

Reference

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