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Causes of hypereosinophilia in 100 consecutive patients
Author(s) -
Moller Daniel,
Tan Julia,
Gauiran Deonne Thaddeus V.,
Medvedev Nadia,
Hudoba Monika,
Carruthers Mollie N.,
Dehghan Natasha,
Berghe Janette,
Bruyère Helene,
Chen Luke Y.C.
Publication year - 2020
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13437
Subject(s) - hypereosinophilia , eosinophilia , medicine , granulomatosis with polyangiitis , hypereosinophilic syndrome , context (archaeology) , eosinophilic , vasculitis , dermatology , pathology , immunology , gastroenterology , disease , paleontology , biology
Background Hypereosinophilia (HE, persistent peripheral blood eosinophilia > 1.5 × 10 9 /L) and hypereosinophilic syndrome (HES, HE with end‐organ damage) are classified as primary (due to a myeloid clone), secondary (due to a wide variety of reactive causes), or idiopathic. Diagnostic evaluation of eosinophilia is challenging, in part because secondary causes of HE/HES such as lymphocyte‐variant HES (L‐HES) and vasculitis are difficult to diagnose, and emerging causes such as immunoglobulin G4‐related disease (IgG4‐RD) have rarely been examined. Objective and Methods We reviewed 100 consecutive patients with HE/HES who underwent extensive evaluation for primary and secondary eosinophilia at a single tertiary care center to determine causes of HE/HES in a modern context. Results Six patients had primary HE/HES, 80 had a discrete secondary cause identified, and 14 had idiopathic HE/HES. The most common causes of secondary eosinophilia were L‐HES/HES of unknown significance (L‐HESus) (20), IgG4‐RD (9), and eosinophilic granulomatosis with polyangiitis (EGPA) (8). Conclusions In contrast to other large published series of HE/HES, most patients in this study were found to have a discrete secondary cause of eosinophilia and only 14 were deemed idiopathic. These findings highlight the importance of extensive evaluation for secondary causes of eosinophilia such as L‐HES, IgG4‐RD, and EGPA.