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Romanian Journal of Internal Medicine

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Eosinophilia and Hypereosinophilic Disorders – Update on Etiopathogeny, Classification and Clinical Approach

Polliana Mihaela Leru
  • Corresponding author
  • “Colentina” Clinical Hospital, Bucharest, Romania
  • “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
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Published Online: 2015-12-10 | DOI: https://doi.org/10.1515/rjim-2015-0049

Abstract

Eosinophils are innate immune leukocytes recruited in large numbers to sites of allergic inflammation and parasitic infections. Recent studies show additional pleiotropic effects of recruited eosinophils impacting immunomodulation, tissue homeostasis and repair. Pathologic conditions accompanied by blood eosinophilia are quite frequent in medical practice and may raise serious differential diagnosis problems in severe cases, that require a multidisciplinary approach. Hypereosinophilia may be reactive to other diseases or primary, representing hypereosinophilic syndromes, that are diagnosed based on clinical and laboratory criteria, according to actual international guidelines. The etiopathogenic diagnosis is difficult and delayed in many cases and clinical evolution may be severe, with multiorgan involvement and poor prognosis. Some cases remain idiopathic, despite exhaustive investigation. This paper aims to review the most recent data in the literature referring to the role of eosinophils in human pathology, diagnostic criteria and treatment strategies of hypereosinophilic syndromes, actual classification and to draw some useful recommendations in clinical practice.

Eozinofilele sunt leucocite care intervin în răspunsurile imune înnăscute, fiind asociate în general cu inflamaţia alergică şi infecţiile parazitare. Studii recente evidenţiază efecte pleiotrope adiţionale ale eozinofilelor în procese imunomodulatoare, de homeostazie şi reparare tisulară. Afecţiunile însoţite de hipereozinofilie sunt relativ frecvente în practica medicală şi ridică adesea probleme de diagnostic diferenţial greu de rezolvat, care necesită o abordare multidisciplinară. Hipereozinofilia poate fi secundară, reactivă în cadrul altor boli sau primară, reprezentând sindroamele hipereozinofilice. Acestea sunt diagnosticate pe baza unor criterii clinice şi paraclinice definite, conform ghidurilor internaţionale actuale. Diagnosticul etiologic este de multe ori dificil şi tardiv, iar evoluţia poate fi severă, cu afectare multiorganică şi deces. Unele cazuri pot rămâne idiopatice, în ciuda investigaţiilor exhaustive. Articolul de faţă îşi propune o evaluare a celor mai recente date din literatură privind rolul eozinofilelor în patologia umană, abordarea diagnostică şi terapeutică a sindroamelor hipereozinofilice şi unele consideraţii utile în practica medicală.

Keywords: eosinophils; hypereosinophilic syndromes; multidisciplinary approach

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About the article

Received: 2015-06-01

Published Online: 2015-12-10

Published in Print: 2015-12-01


Citation Information: Romanian Journal Of Internal Medicine, ISSN (Online) 1220-4749, DOI: https://doi.org/10.1515/rjim-2015-0049.

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© 2015 Polliana Mihaela Leru, published by De Gruyter Open. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License. BY-NC-ND 3.0

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