Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Romanian Journal of Internal Medicine

4 Issues per year

Open Access
See all formats and pricing
More options …

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
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2015-12-10 | DOI: https://doi.org/10.1515/rjim-2015-0049


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


  • 1. MOQBEL R, LACY P, ADAMKO DJ, ODEMUYIWA SO. Biology of Eosinophils. In Middleton’s Allergy Principles and Practice, Seventh Edition. Cap 18, p. 295-310.Google Scholar

  • 2. LACY P, MOQBEL R. Immune effector functions of eosinophils in allergic airway inflammation. Curr Opin Allergy Clin Immunol 2001; 1:79-84.Google Scholar

  • 3. VALENT P, KLION AD, ROSENWASSER LJ, et al. ICON (International Consensus ON): Eosinophilic Disorders. Consensus document. WAO Journal 2012; 5:174-181.Google Scholar

  • 4. GOTLIB J. World Health Organization – defined eosinophilic disorders: 2014 update on diagnosis, risk stratification and management. American Journal of Hematology 2014; 89(3):326-37.Google Scholar

  • 5. GLEICH GJ. Mechanisms of eosinophil-associated inflammation. J Allergy Clin Immunol 2000; 105: 651-63.Google Scholar

  • 6. HOGAN SP, ROSENBERG HF, MOQBEL R, et al. Eosinophils: biological properties and role in health and disease. Clin Exp Allergy 2008; 38:709-50.Web of ScienceGoogle Scholar

  • 7. WOERLY G, ROGER N, LOISEAU S, et al. Expression of CD28 and CD86 by human eosinophils and role in the secretion of type 1 cytokines (interleukin 2 and interferon gama: inhibition by immunoglobulin complexes. J Exp Med 1999; 190:487-495.Google Scholar

  • 8. PARDANANI A, PATNAIK MM, TEFFERI A. Eosinophilia: Secondary, clonal and idiopathic. Br J Haematol 2006; 133:468-92.Google Scholar

  • 9. GOTLIB J, COOLS J. Five years since the discovery of FIP1L1-PDGFRA: what we have learned about the fusion and other molecularly defined eosinophilias. Leukemia 2008; 22: 1999-2010.Web of ScienceGoogle Scholar

  • 10. SIMON HU, ROTHENBERG ME, BOCHNER BS, et al. Refining the definition of hypereosinophilic syndrome. J Allergy Clin Immunol 2010; 126: 45-49.Web of ScienceGoogle Scholar

  • 11. BAIN BJ, GILLILAND DG, HORNY HP, et al. Myeloid and lymphoid neoplasms with eosinophilia and abnormalities of PDGFRA, PDGFRB or FGFR1. World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues. Lyon, France: IARC Press, 2008, p. 68-73.Google Scholar

  • 12. VALENT P, KLION AD, HORNY HP, ROUFOSSE F, GOTLIB J, et al. Contemporary consensus proposal on criteria and classification of eosinophilic disorders and related syndromes. J Allergy Clin Immunol 2012; 130:607-612.Web of ScienceGoogle Scholar

  • 13. CHUSID MJ, DALE DC, WEST BC, WOLF SM. The hypereosinophilic syndrome: analysis of fourteen cases with review of the literature. Medicine 1975; 54: 1-27.Google Scholar

  • 14. KLION AD. Recent advances in the diagnosis and treatment of hypereosinophilic syndromes. Hematology 2005; 209-14.CrossrefGoogle Scholar

  • 15. VAGLIO A, BUZIO C, ZWERINA J. Eosinophilic granulomatosis with polyangiitis (Churg – Strauss): state of the art. Allergy 2013; 68: 261-73.Web of ScienceGoogle Scholar

  • 16. LEFEBVRE C, BLETRY O, DEGOULET P, et al. Prognostic factors of hypereosinophilic syndrome. Study of 40 cases. Ann Med Interne (Paris) 1989; 140:253-7.Google Scholar

  • 17. PODJASEK JC, BUTTERFIELD JH. Mortality in hypereosinophilic syndrome: 19 years of experience at Mayo Clinic with a review of the literature. Leuk Res 2013; 37:392-5.Web of ScienceGoogle Scholar

  • 18. KLION AD. How I treat hypereosinophilic syndromes. Blood 2009;114(18): 3736-41.Google Scholar

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, Volume 53, Issue 4, Pages 289–295, ISSN (Online) 1220-4749, DOI: https://doi.org/10.1515/rjim-2015-0049.

Export Citation

© 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

Comments (0)

Please log in or register to comment.
Log in