TAILIEUCHUNG - Chapter 061. Disorders of Granulocytes and Monocytes (Part 11)

Eosinophilia Eosinophilia is the presence of 500 eosinophils per µL of blood and is common in many settings besides parasite infection. Significant tissue eosinophilia can occur without an elevated blood count. A common cause of eosinophilia is allergic reaction to drugs (iodides, aspirin, sulfonamides, nitrofurantoin, penicillins, and cephalosporins). Allergies such as hay fever, asthma, eczema, serum sickness, allergic vasculitis, and pemphigus are associated with eosinophilia. Eosinophilia also occurs in collagen vascular diseases (., rheumatoid arthritis, eosinophilic fasciitis, allergic angiitis, and periarteritis nodosa) and malignancies (., Hodgkin's disease; mycosis fungoides; chronic myeloid leukemia; and cancer of the lung, stomach, pancreas,. | Chapter 061. Disorders of Granulocytes and Monocytes Part 11 Eosinophilia Eosinophilia is the presence of 500 eosinophils per pL of blood and is common in many settings besides parasite infection. Significant tissue eosinophilia can occur without an elevated blood count. A common cause of eosinophilia is allergic reaction to drugs iodides aspirin sulfonamides nitrofurantoin penicillins and cephalosporins . Allergies such as hay fever asthma eczema serum sickness allergic vasculitis and pemphigus are associated with eosinophilia. Eosinophilia also occurs in collagen vascular diseases . rheumatoid arthritis eosinophilic fasciitis allergic angiitis and periarteritis nodosa and malignancies . Hodgkin s disease mycosis fungoides chronic myeloid leukemia and cancer of the lung stomach pancreas ovary or uterus as well as in Job s syndrome and CGD. Eosinophilia is commonly present in the helminthic infections. IL-5 is the dominant eosinophil growth factor. Therapeutic administration of the cytokines IL-2 and GM-CSF frequently leads to transient eosinophilia. The most dramatic hypereosinophilic syndromes are Loeffler s syndrome tropical pulmonary eosinophilia Loeffler s endocarditis eosinophilic leukemia and idiopathic hypereosinophilic syndrome 50 000-100 000 pL . The idiopathic hypereosinophilic syndrome represents a heterogeneous group of disorders with the common feature of prolonged eosinophilia of unknown cause and organ system dysfunction including the heart central nervous system kidneys lungs gastrointestinal tract and skin. The bone marrow is involved in all affected individuals but the most severe complications involve the heart and central nervous system. Clinical manifestations and organ dysfunction are highly variable. Eosinophils are found in the involved tissues and likely cause tissue damage by local deposition of toxic eosinophil proteins such as eosinophil cationic protein and major basic protein. In the heart the pathologic changes lead to .

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