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Oral mucosa lesions in hypereosinophilic syndrome – an update
Author(s) -
Ionescu MA,
Murata H,
Janin A
Publication year - 2008
Publication title -
oral diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.953
H-Index - 87
eISSN - 1601-0825
pISSN - 1354-523X
DOI - 10.1111/j.1601-0825.2007.01393.x
Subject(s) - medicine , hypereosinophilic syndrome , oral mucosa , pathology , eosinophilia , imatinib mesylate , lymphoma , myeloid , myeloid leukemia , imatinib , immunology
Hypereosinophilic syndrome (HES) is a rare disorder characterized by persistent and marked eosinophilia. Some HES forms have a poor prognosis, either because of end‐organ damage (particularly endomyocardial fibrosis), or because of associated myeloid leukemia or malignant T‐cell lymphoma. Oral mucosa ulcerations can be early clinical signs in severe forms. They are discrete, round or oval, sometimes confluent ulcers or erosions, located on non‐keratinized, unattached oral mucosa. In the last 15 years a better understanding of eosinophil biology has led to a new clinical classification of HES. The lymphocytic form is characterized by T‐lymphocyte clonality, IL‐5 production, and a possible progression to T‐cell lymphoma. Oral lesions are more frequently associated with the myeloproliferative form, characterized by an increased risk of developing myeloid malignancies and a good response to a recent anti‐tyrosine kinase therapy (imatinib mesylate). The target of imatinib is a novel kinase resulting from an 800‐kb deletion on chromosome 4. Recently, the resulting FIP1L1‐PDGFR α fusion gene was characterized as a marker of response to imatinib. Exclusion of other erosive ulcerative oral disease and early recognition of HES in patients with oral ulcerations, and precise characterization of the lymphocytic or myeloproliferative form are therefore important to rapidly initiate an effective therapy.