| Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access |
| Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc |
| Journal website http://www.jocmr.org |
Case Report
Volume 2, Number 5, October 2010, pages 233-238
Hypereosinophilia: A Diagnostic Dilemma
Table
| Causes of hypereosinophilia | Reasons for exclusion in our patient |
|---|---|
| Adopted from reference [2] | |
| Systemic diseases Churg-Strauss syndrome Wegener’s syndrome Polyarteritis nodosa Cholesterol crystal embolism Eosinophilic fasciitis Rheumatoid arthritis | Negative chest X-ray and CT scan Negative ANCA antibodies, negative ANA, negative rheumatoid factor |
| Eosinophilic pneumonias Drug-induced pneumonias Loffler’s syndrome Allergic bronchopulmonary aspergillosis Churg-Strauss syndrome Eosinophilic pneumonia | Normal Chest X-ray and CT results Although high serum IgE levels, no other features of ABPA,negative immunodiffusion test for aspergillus |
| Malignancies and immunodeficiencies Hodgkin lymphoma Non-Hodgkin lymphoma Acute and chronic leukaemia Epithelial cancers Hyper-IgE syndrome Ommen syndrome | Absence of lymphadenopathy clinically and on imaging studies, absence of clonal karyotypic abnormalities. Normocellular normoblastic bone marrow |
| Skin diseases Bullous pemphigoid Cutaneous T-cell lymphoma Systemic mastocytosis Kimura disease Wells disease Eosinophilic pustular folliculitis | No evidence of skin disease |
| Drug-induced eosinophilia Anticonvulsants Non-steroidal anti-inflammatory drugs Antimicrobial agents Sulfa drugs | No history of exposure to drugs known to cause eosinophilia |
| Gastrointestinal diseases Crohn’s disease Eosinophilic gastroenteritis | No clinical features (diarrhea, abdominal pain) suggestive of gastrointestinal disease |
| Infections Helminthic diseases Human immunodeficiency virus (HIV), Human T-lymphocyte virus 1 (HTLV1) Tuberculosis | Negative stool studies, no history of travel to endemic areas No risk factors for HIV or FTLV1 Normal chest X-ray and CT scan |