Canterbury DHB
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This section provides a basic review of the work-up and management of eosinophilia. For a more comprehensive review, see the 2017 BCSH guidelines (Butt NM, et al.).1
Eosinophils arise from CD34 positive cells, which are often pre-committed progenitors bipotent for eosinophils and basophils. They produce and store pro-inflammatory proteins and cytokines which, when chronically in excess, may cause tissue and/or organ damage. Work-up should therefore include assessing organ damage, as guided by symptoms. Hypereosinophilia is generally defined as a peripheral blood eosinophil count >1.5 x 109/L.
There are numerous reactive/secondary causes of eosinophilia, many of which are included in the table below. A thorough history, careful examination, and often targeted investigation are required to exclude a secondary cause. However, the 2017 BCSH guidelines1 recommend that all patients have as a minimum initial blood panel:
Manage a reactive eosinophilia by treating the underlying condition. If the underlying condition is not amenable to treatment, the eosinophilia itself can often be managed with corticosteroids or hydroxyurea.
See the 2017 BCSH guidelines,1 table 2 page 5 for causes of eosinophilia.
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Topic Code: 6246
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