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PubMedDate not supplied

Aetiological diagnosis in permanent residents of Punjab presenting with chest complaints and high peripheral blood eosinophilia.

Sixty-six permanent residents of Punjab, presenting with chest complaints and absolute eosinophil counts (AEC) over 2000 per cumm were investigated to find out the cause of high eosinophilia. Tropical pulmonary eosinophilia (TE) was responsible for high eosinophilia in 27 cases (40.9%), even in this region where filariasis is not endemic. Severe asthma (23 cases), allergic bronchopulmonary aspergillosis (ABPA-5 cases), drug reaction (2 cases) and chronic eosinophilic pneumonia (2 cases) in adults and ascariasis (6 cases) in children were other main causes of high eosinophilia. It is emphasized that all cases with high blood eosinophilia should not be labelled as cases of TE simply on the basis of AEC over 2000 per cumm. This is all the more important for non-filarial regions. Only a systematically conducted work up can clinch the correct diagnosis in such cases.

Adolescent↗

PubMed1994

Chronic sinusitis. Relationship of computed tomographic findings to allergy, asthma, and eosinophilia.

OBJECTIVE: To develop a technique for evaluating the severity of chronic sinus disease and to examine the correlation with allergy, asthma, and eosinophilia. DESIGN: A survey of 104 patients undergoing surgery for chronic sinusitis. SETTING: A university hospital ear, nose, and throat clinic. PATIENTS: A referral population of adult patients being scheduled for endoscopic sinus surgery was eligible; 104 completed questionnaires and agreed to participate. MAIN OUTCOME MEASURES: Computed tomographic scans were reviewed and scored for extent of disease. Serum samples were assayed for total IgE and specific IgE antibodies to common inhalant allergens. Peripheral blood samples were analyzed for total eosinophil count. Surgical biopsy specimens were examined for eosinophilia and cultured for bacteria and fungi. RESULTS: Extensive disease was present in 39% of subjects and correlated well with asthma, specific IgE antibodies, and eosinophilia, but not with elevated total IgE. Among patients with peripheral eosinophilia, 87% had extensive disease. All cultures grew aerobic bacteria; anaerobes and fungi were uncommon. CONCLUSIONS: We present a system for quantitation of disease extent using computed tomographic scans of patients with chronic sinusitis. The well-accepted associations of chronic sinusitis with asthma and allergy appear to be restricted to the group with extensive disease. The presence of peripheral eosinophilia in patients with sinusitis indicates a high likelihood of extensive disease.

Adult↗

PubMed1990

Fasciitis, perimyositis, myositis, polymyositis, and eosinophilia.

Several groups of cases of fasciitis and myositis with eosinophilia are reported. The common features are inflammation into fascia and/or perimysium, and/or muscle fibers; eosinophilia in blood and/or in muscle biopsy. The following classification of 24 cases is suggested: at one end of the spectrum are fasciitis with eosinophilia: diffuse fasciitis (Shulman syndrome): 10 cases (3 with hematological complications); 2 cases of diffuse fasciitis with muscle atrophy; 3 cases of restricted fasciitis. Relapsing perimyositis with eosinophilia belong to the same spectrum, either diffuse (5 cases) with myalgias, or localized (2 cases). Other cases are focal myositis or multiple myositis, polymyositis with eosinophilia. The relationship among these cases is discussed. There is a continuum among the different groups. The pathophysiology remains unknown.

Adult↗

PubMed2005

Comparative proteomic analysis of peripheral blood eosinophils from healthy donors and atopic dermatitis patients with eosinophilia.

Atopic dermatitis (AD) is an allergic disease that has recently shown a dramatic increase of incidence in developed countries. Eosinophilia, the accumulation of eosinophils, occurs in AD patients through an anti-apoptotic mechanism. To understand the target proteins involved in the anti-apoptotic signaling of eosinophilia, we used a proteomic approach to analyze eosinophil proteins from AD patients with eosinophilia and healthy donors. Protein spots in two-dimensional electrophoresis (2-DE) gels were identified with peptide mass fingerprinting (PMF) based on matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) and database searching. More spots were observed in the 2-DE proteome map from AD patient samples (1310 +/- 58 spots) than in those from healthy donors (1121 +/- 40 spots). We identified 51 proteins affected by eosinophilia: 19 related to signaling, 8 involved in regulation of metabolism, 4 related to apoptosis, and 3 involved in inflammation. The other identified proteins were associated with transcription, RNA processing, translation, the cytoskeleton, and unknown functions. Among the identified proteins, we observed prominent increases in the expressions of cyclinA2, voltage-dependent anion channel protein 2, and 38 kDa FK506 binding protein 8 in eosinophils from AD patients in comparison to healthy donors. PMF and immunoblotting of a single spot that was expressed in eosinophils from healthy individuals but not in AD patients identified the protein as phosphorylated growth receptor binding 7 (Grb7) adaptor protein. Increased phosphorylation of Grb7 and its upstream signaling protein, focal adhesion kinase (FAK), was detected in low viability eosinophils such as those from healthy donors or in cultured eosinophils (AML14.3D10 cells) treated with dexamethasone. These results suggest that phosphorylation of Grb7 and the expressions of cyclinA2, voltage-dependent anion channel protein 2, and 38 kDa FK506 binding protein 8 may be related with the anti-apoptosis mechanism of eosinophilia.

Apoptosis↗

PubMed2003

Correlations between exhaled nitric oxide levels, blood eosinophilia, and airway obstruction reversibility in childhood asthma are detectable only in atopic individuals.

The aim of this study was to compare in atopic and nonatopic asthmatic children correlations between two inflammation parameters, i.e., blood eosinophilia and exhaled nitric oxide (FE(NO)), and pulmonary function values, at baseline and after beta(2)-adrenergic bronchodilators. Ninety-two steroid-naive asthmatic children were evaluated: 26 were skin prick test- and RAST-negative (nonatopic subjects), whereas 66 were atopic, 15 being sensitized only to house dust mites (monosensitized) and 51 to mites and to at least one other class of allergens (polysensitized). Baseline spirometric values (FEV(1) and FEF(25-75%)) were similar in atopic and nonatopic groups (P > 0.1, each comparison). However, when compared to nonatopic subjects, atopic children showed a significantly higher degree of blood eosinophilia (3.0% and 6.7% white blood cell count, respectively; P = 0.0001) and higher FE(NO) levels (6.8 ppb and 16.0 ppb, respectively; P = 0.0001). While a positive correlation between FE(NO) levels and blood eosinophilia was observed in atopic children (r = 0.25, P = 0.041), no correlations between these two inflammation parameters and baseline pulmonary function values were demonstrated in any of the asthmatic groups. Inhalation of a beta(2)-agonist drug induced in the two asthmatic populations similar improvements in FEV(1) and FEF(25-75%) and no changes in FE(NO) levels or blood eosinophilia. However, only in atopic children positive correlations were found between percent variation in FEV(1) (delta%FEV(1)) and FE(NO) levels (r = 0.35, P = 0.006) or blood eosinophilia (r = 0.26, P = 0.04). Within the atopic group, no differences were found between mono- and polysensitized individuals in all parameters evaluated. Thus only in atopic children did parameters of inflammation correlate with airway obstruction reversibility.

Adrenergic beta-Agonists↗

PubMed2002

Fludarabine-induced eosinophilia: case report.

Eosinophilia induced by nucleoside analogs has been described in a handful of case reports and during the treatment of both chronic lymphocytic leukemia (CLL) and follicular non-Hodgkin's lymphoma (NHL). This paper reports an additional case of fludarabine-induced eosinophilia during the treatment of CLL. The patient, a 58-year-old man, developed peripheral eosinophilia with a peak value of 1.7x10(9)/l 5 months after the beginning of treatment with fludarabine. A thorough investigation for other causes of eosinophilia was negative and the eosinophilia subsided after the completion of the treatment.

Antineoplastic Agents↗

PubMed2006

The prevalence and diagnostic value of toxocariasis in unknown eosinophilia.

Toxocariasis is one of the causes of eosinophilia in peripheral blood and provokes eosinophilic infiltration in internal organs. Extended studies on the prevalence and clinical characteristics of toxocariasis have been rare. The aim of this study is to evaluate the prevalence of toxocariasis in unknown eosinophilia and to analyze the efficacy of toxocara enzyme-linked immunosorbent assay (ELISA). We evaluated patients presenting with peripheral blood eosinophilia (>500 cells/microl or > or =10% of white blood cell count). After checking drug histories and the presence of allergic diseases and parasitic infections, specific serum IgG antibody to Toxocara canis larval antigen was measured by ELISA. Liver and lung involvement was also evaluated. One-hundred and three patients were evaluated, and the mean age was 50.9 years old. Seventy patients (68.0%) were diagnosed as having toxocariasis. The patients who had a history of raw liver eating had a higher incidence, and the patients with liver involvement had higher serum eosinophil cationic protein values. The eosinophil count was normalized in 7 of 16 treated patients and in 25 of 54 untreated patients. The mean improvement duration was 12 months. We concluded that the prevalence of toxocariasis was high in patients with unknown eosinophilia, and the toxocara ELISA was essential for evaluation of the causes of unknown eosinophilia.

Administration, Oral↗

PubMed1993

The effect of cyclosporin A on Angiostrongylus cantonensis infection and eosinophilia in mice.

Male BALB/c mice were infected with Angiostrongylus cantonensis and at various times p.i. treated with cyclosporin A (CsA) either for 5 days continuously or intermittently, or for 12-16 days on alternate days. They were monitored for peripheral blood eosinophilia and at necropsy examined for CSF and bone marrow eosinophilia, and worm recovery. CsA treatment provoked a transient inhibition of peripheral blood eosinophilia in all groups examined, followed by rebounding eosinophilia. There was no significant difference in bone marrow and CSF eosinophilia between CsA- and vehicle-treated groups. Mice treated with CsA on alternate days yielded lower intracranial worm recovery with small-sized worms at days 7, 21 and 30 p.i. than vehicle-treated groups did. No significant reduction in worm recovery was noted in mice treated for 5 days either continuously or intermittently, although worms, especially female ones, harvested from groups treated with CsA from days--1 to 3 or from days 13 to 17 were significantly smaller than those from vehicle-treated groups. CsA-treatment suppressed blastogenic responses of spleen cells against Con A or worm antigen at days 7 and 21 p.i. In vitro treatment of the 3rd stage larvae with CsA did not adversely influence survival of A. cantonensis in mice. These data indicate that CsA exerts anti-parasitic effects against A. cantonensis in mice.

Angiostrongylus cantonensis↗

PubMed1986

Abnormal nucleotide pattern in the eosinophils of a patient with acute lymphoblastic leukemia associated with eosinophilia.

In this article we present a patient with acute lymphoblastic leukemia (ALL) associated with eosinophilia, in which the eosinophilia preceded a meningeal and bone-marrow relapse of ALL. We analysed the purine and pyrimidine nucleotide content of the eosinophils (92% pure) and compared the nucleotide pattern with that of eosinophils from healthy donors and from patients with eosinophilia not associated with leukemia. The ratios of purine:pyrimidine and of uracil:cytosine nucleotides were decreased compared with those in eosinophils from healthy donors and from patients with eosinophilia with other aetiologies. The total nucleotide concentration was increased, especially the concentration of UDP-sugars and pyrimidine nucleotides. The decrease in these ratios and the increase in concentration of the nucleotides and the UDP-sugars were also detected in leukemic cells of patients with ALL (de Korte et al., Leukemia Res. 10, 389-396 (1986) compared to normal lymphocytes. We suggest a malignant character of the eosinophils in our patient with ALL associated with eosinophilia, in contrast with the non-malignant state suggested previously for these cells.

Adult↗

PubMed2004

The effects of fexofenadine on eosinophilia and systemic anaphylaxis in mice infected with Trichinella spiralis.

BACKGROUND: The effects of the non-impairing, H(1)-receptor antagonist fexofenadine were investigated in in vivo mouse models of eosinophilia and systemic anaphylaxis. METHODS: Eosinophilia was investigated in C57BL/6 mice (n=5 per group) infected with Trichinella spiralis, with and without administration of fexofenadine HCl (5, 10 and 20 mg/kg/day). Eosinophilia was also studied, with and without fexofenadine administration, in mice with a congenital mast-cell deficiency (W/W(v)) and controls (+/+). The effect of fexofenadine HCl (20 mg/kg/day) on IL-5 and eotaxin blood levels was also investigated in C57BL/6 mice. In a separate model, systemic anaphylaxis was induced in C57BL/6 mice using T. spiralis antigen. Fexofenadine HCl (5, 10 and 20 mg/kg) or vehicle was administered 20 min before antigen challenge (n=5 per group). The effect of fexofenadine on systemic anaphylaxis caused by IgE and anti-IgE was also examined in CBF1 mice injected with serum from NC/Nga mice with high IgE levels. Rectal temperature was measured as an indicator of anaphylaxis. RESULTS: In C57BL/6 mice, repetitive oral administration of fexofenadine HCl (5, 10 and 20 mg/kg/day) resulted in dose-dependent suppression of eosinophilia (p<0.05-0.0001). No suppression was observed in mast-cell deficient W/W(v) mice. In addition, single oral administration of fexofenadine HCl (10 and 20 mg/kg) significantly suppressed the decrease in rectal temperature (p<0.01), a marker for systemic anaphylaxis, in C57BL/6 mice. In CBF1 mice injected with serum from NC/Nga mice with high IgE levels, the decrease in rectal temperature was suppressed by single administration of fexofenadine HCl (10 and 20 mg/kg; p<0.01 and p<0.001, respectively). Fexofenadine had no effect on peripheral IL-5 and eotaxin levels. CONCLUSION: These results indicate that fexofenadine suppresses both eosinophilia and systemic anaphylaxis, both of which are fundamental reactions in allergic diseases.

Anaphylaxis↗

PubMed2005

Leukocytosis and blood eosinophilia in a polyparasitised population in north-eastern Brazil.

It has long been known that leukocytosis and blood eosinophilia are common in the tropical environment, but data derived from population-based studies are scarce. A study was undertaken in a fishing village in north-east Brazil where both intestinal helminthiases and parasitic skin diseases are common. Of 409 individuals studied, 128 (31.3%) were infected with one intestinal helminth or ectoparasite species, 93 (22.7%) with two, 61 (14.9%) with three, 25 (6.1%) with four and 11 (2.7%) with more than four species; no parasites were found in 91 (22.2%) individuals. Leukocyte counts ranged between 3,300 cells/microl and 16,100 cells/microl (median, 7,200 cells/microl) and eosinophil counts between 40 cells/microl and 5,460 cells/microl (median, 455 cells/microl). Eosinophilia (>500/microl) was detected in 44.7% of the individuals, and hypereosinophilia (>1,000/microl) in 12.9%. Thirty-six (8.8%) individuals showed leukocytosis. While 75% of individuals with normal eosinophil counts were considered parasite-free, only 14% with eosinophilia and 11% with hypereosinophilia did not have enteroparasites or ectoparasites. Multivariate regression showed that the probability of eosinophilia and hypereosinophilia, but not of leukocytosis, increased with the number of parasite species present. The data show that eosinophilia occurs in almost one-half of the individuals from a resource-poor setting and that it is significantly associated with the presence of intestinal helminths, but not with the presence of ectoparasites.

Adolescent↗

PubMed1981

The pattern of eosinophilia in premature infants. A prospective study in premature infants using the absolute eosinophil count.

The incidence and severity of eosinophilia was prospectively studied in 45 premature infants, who were divided into three groups according to their gestational age. The incidence and severity of eosinophilia was higher in small preterm infants. A significantly higher number of infants with eosinophilia received total parenteral nutrition, endotracheal intubation, or blood transfusions. The duration of total parenteral nutrition or endotracheal intubation and the number of blood transfusions were also significantly higher in infants with eosinophilia. Eosinophilia in premature infants is not associated with neutropenia.

Birth Weight↗

PubMed1992

Eosinophilia in travelers.

Eosinophilia in travelers may be caused by infections acquired during travels. Infections with helminthic, but not protozoan, parasites are the most likely causes of eosinophilia, although other etiologies may warrant consideration. This article reviews the parasitic and other causes of eosinophilia. Helminthic infections early in their development may elicit the most pronounced eosinophilia yet be difficult to diagnose. Chronic helminthic infections may yield eosinophilia that persists for prolonged periods of time after initial infection.

Eosinophilia↗

PubMed1990

The relationship of eosinophilia and positive skin test reactivity to respiratory symptom prevalence in a community-based population study.

We studied the relationship of the prevalence of a variety of respiratory symptoms to positive skin test reactivity (skin test index greater than or equal to 3) and/or eosinophilia (greater than or equal to 275 eosinophilic cells per cubic millimeter of blood) in a community-based population sample (N = 2805), adjusting for age, gender, area of residence, and cigarette smoking. We considered subjects with neither positive skin test reactivity nor eosinophilia to be the reference group. Positive skin test reactivity without eosinophilia (N = 487; 17.3%) was significantly associated with persistent wheeze (odds ratio value (OR) = 1.6; 95% confidence interval of the odds ratio value (CI) = 1.0 to 2.6) and with asthmatic attacks (OR = 3.2; CI = 2.0 to 5.3). Positive skin test reactivity in combination with eosinophilia (N = 92; 3.3%) was also significantly associated with persistent wheeze (OR = 2.7; CI = 1.2 to 6.0) and with asthmatic attacks (OR = 10.4; CI = 5.3 to 20.2), however, with a stronger association than in subjects with positive skin test reactivity alone. Finally, eosinophilia without positive skin test reactivity (N = 170; 6.1%) was significantly associated with chronic cough (OR = 1.8; CI = 1.2 to 2.7), bronchitis episodes (OR = 2.1; CI = 1.4 to 3.2), dyspnea grade greater than or equal to III (OR = 1.7; CI = 1.0 to 2.8), and asthmatic attacks (OR = 3.0; CI = 1.5 to 6.6).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed2000

Eosinophilia in the neonatal intensive care unit.

Although common in the neonatal intensive care unit, eosinophilia is often overlooked or ignored. The latter might be, at least in part, because evaluating the neonate with eosinophilia can be a complex process. This article reviews the physiologic features of eosinophilia, reference ranges, and clinical conditions associated with eosinophilia in the neonate. Recommendations for the evaluation of the neonate with eosinophilia are presented.

Eosinophilia↗

PubMed1983

Bullous pemphigoid: a cause of peripheral blood eosinophilia.

A retrospective study demonstrated that fourteen of twenty-eight patients (50%) with clinical, histologic, and immunofluorescent findings of bullous pemphigoid had peripheral blood eosinophilia. Blood eosinophilia ranged from 5% to 43% when first tested, with increase in one patient to 56% during treatment. The pathophysiologic cause of blood eosinophilia in bullous pemphigoid is discussed with its relationship to previously demonstrated elevations of IgE and eosinophilic chemotactic factor of anaphylaxis (ECF-A) in serum and blister fluid. Peripheral blood eosinophilia was a common finding in our group of patients, and bullous pemphigoid should be included in the differential diagnosis of bullous skin conditions with eosinophilia.

Eosinophilia↗

PubMed2000

Allergen-induced bronchial eosinophilia in guinea-pigs is inhibited by both pre- and post-induction cyclosporin-A treatments.

Repeated treatment of sensitized guinea-pigs with cyclosporin-A (CS-A) before aerosol allergen challenge is known to inhibit the subsequent bronchial eosinophilia. It is not known, however, if the drug is also effective on established/on-going bronchial eosinophilia. We have, therefore, studied the effect of CS-A on allergen-induced eosinophil recruitment into the bronchoalveolar lavage (BAL) fluid of guinea-pigs when given before or after induction.Ovalbumin-immunized guinea-pigs were treated with CS-A (20 mg/kg subcutaneously) or vehicle daily for varying periods before a single aerosol allergen challenge. In animals in which bronchial eosinophilia was maintained with repeated aerosol allergen challenge, CS-A or vehicle was given daily for varying periods after the first allergen challenge. BAL and cell count were performed 24 h after the last challenge. In vehicle-treated animals, a single allergen challenge caused a 4-5 fold increase in the number of eosinophils in the BAL fluid after 24 h, declining to baseline by 7 days. In repeatedly-challenged animals, this response was sustained throughout. Eosinophil infiltration was significantly inhibited when CS-A was given daily for 7-14 days, but not for 1 or 3 days, before allergen challenge. When given during an established/on-going eosinophil infiltration, a significant inhibition was seen after administration for 5 or 7 days, but not for 1 or 3 days.These results show that repeated CS-A administration inhibits not only the induction of allergic bronchial eosinophilia but also the maintenance of an established one. This may be relevant in the treatment of allergic diseases, such as asthma, in which drug administration often begins when eosinophilia is already established.

Administration, Inhalation↗

PubMed2003

Heterogeneity of interleukin 5 genetic background in atopic dermatitis patients: significant difference between those with blood eosinophilia and normal eosinophil levels.

BACKGROUND: Blood eosinophil levels in patients with atopic dermatitis vary widely during exacerbation of the disease. We considered that in addition to environmental factors, the genetic background involved with elevating blood eosinophil levels might be heterogeneous among atopic dermatitis patients. OBJECTIVE: We attempted to determine whether a polymorphism of the interleukin (IL)5 gene plays a role in atopic dermatitis, particularly in those patients with blood eosinophilia. Due to the close relation of blood eosinophilia to high IgE productivity, we also assessed these polymorphisms in patients with high IgE concentrations. METHODS: We determined the genotype of the IL5 polymorphism -703C/T in 451 atopic dermatitis patients and 116 normal subjects. The patients were classified into three groups by blood eosinophil levels; less than 7%, from 7 to 15%, and more than 15%, as well as by serum IgE concentrations; less than 500 IU/ml, from 500 to 2000 IU/ml, and more than 2000 IU/ml. RESULTS: IL5 -703C/T was not significantly associated with either total atopic dermatitis patients or individual patients who had both blood eosinophilia and high IgE productivity. However, the distribution of the IL5 -703C/T genotype was significantly different between patients with either blood eosinophilia or high IgE productivity and those without either condition (P=0.0476, P=0.0088, respectively). CONCLUSION: These results suggest that the IL5 gene may play a role in blood eosinophilia associated with atopic dermatitis. We also considered that the IL5 -703C/T gene polymorphism does not have a direct relationship to disease specificity.

Adolescent↗