Open AccessHypereosinophilia as a presenting sign of acute graft-versus-host disease after allogeneic bone marrow transplantation
Author(s) -
Douglas G. McNeel,
MarieThérèse Rubio,
Ghandi Damaj,
JF Émile,
Coralie Bélanger,
B Varet,
Nicole Brousse,
Olivier Hermine,
Agnès Buzyn
Publication year - 2002
Publication title -
transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.45
H-Index - 204
eISSN - 1534-6080
pISSN - 0041-1337
DOI - 10.1097/00007890-200212270-00028
Subject(s) - hypereosinophilia , medicine , graft versus host disease , eosinophilia , biopsy , skin biopsy , pathology , bone marrow , transplantation , immunology , disease
The authors report two cases of hypereosinophilia as the major presenting sign of acute graft-versus-host disease (GVHD) after allogeneic bone marrow transplantation (BMT). Tissue biopsies of the skin, salivary gland, gut, and liver showed evidence of acute GVHD (aGVHD). In one case, further investigations have been performed. Elevated levels of interleukin (IL)-5 and soluble IL-2 receptor were found in the blood, and skin biopsy specimens demonstrated high levels of IL-5 messenger ribonucleic acid (mRNA). In contrast, skin biopsy specimens from other patients with aGVHD but without eosinophilia were negative for IL-5 mRNA. The authors also demonstrated the presence of IL-4 and interferon(IFN)-gamma mRNA within the same skin biopsy specimen, suggesting that this case of aGVHD was mediated by both Th1 and Th2 cell type. These two patients were treated by glucocorticoids with resolution of the hypereosinophilia and the symptoms of GVHD. The authors briefly discuss the possible mechanisms of this hypereosinophilia with respect to aGVHD.