Chapter 110 : Diagnosis of Hypereosinophilic Syndromes

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The term hypereosinophilic syndromes (HES) was first used in 1968 by Hardy and Anderson to describe three patients with marked peripheral eosinophilia, hepatosplenomegaly and cardiac and/or pulmonary symptoms. Additional subgroups of HES with distinctive clinical manifestations await characterization at the molecular and immunologic levels. The first step in the diagnosis of HES is to exclude other disorders associated with marked peripheral eosinophilia. These include parasitic infections, drug hypersensitivity reactions, neoplasms, and immunodysregulatory disorders associated with secondary eosinophilia. If routine laboratory results (including human immunodeficiency virus (HIV) testing) and diagnostic testing do not lead to an alternative diagnosis, computed tomography of the chest, abdomen, and pelvis, as well as a bone marrow examination, should be performed in all patients to exclude occult malignancy before a diagnosis of HES is confirmed. Other diagnostic tests that may be helpful in establishing the diagnosis include the measurement of thymus and activationregulated chemokine (TARC) levels in serum and the assessment of the lymphocyte production of eosinophilopoietic cytokines. As the number of chemotherapeutic agents with specific molecular and immunologic targets continues to grow, the resolution of these issues will become increasingly important for the appropriate management of patients with primary eosinophilic disorders.

Citation: Klion A. 2006. Diagnosis of Hypereosinophilic Syndromes, p 984-990. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch110
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Secondary causes of marked eosinophilia

Citation: Klion A. 2006. Diagnosis of Hypereosinophilic Syndromes, p 984-990. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch110
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Evaluation of patients with presumed HES

Citation: Klion A. 2006. Diagnosis of Hypereosinophilic Syndromes, p 984-990. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch110

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