Contributions
Abstract: PB2378
Type: Publication Only
Background
Eosinophilia is mostly caused by allergic or infectious disorders. Only a small proportion are primary clonal needing hematological treatment. Despite that, patients with eosinophilia are frequently referred to hematologists for diagnostic evaluation.
Aims
Analyze characteristics of patients with eosinophilia referred for hematologic evaluation in different hospital types.
Methods
Patients referred to hematologic evaluation for eosinophilia in 2016 were identified by searching electronic data bases of a general and a university hospital. Individual patient data were then extracted from their respective files.
Results
We identified 75 patients fulfilling entry criteria, 20 in the general and 55 in the university hospital. Median age was 58; 36 were male and 39 female. Seven had severe eosinophilia, 30 moderate and 38 mild eosinophilia. Ten patients (13%) had myeloid neoplasms, one with PDGFRA and one with PDGFRB rearrangement; 6 had other myeloproliferative neoplasms and 2 myelodysplasia. Twenty-three patients (31%) had allergic and autoimmune disorders (e.g. asthma, rheumatoid arthritis, polyarteritis nodosa, bullosus pemphigoid, psoriasis, coeliac disease, discoid lupus erythematosus, eosinophilic fasciitis and other), 6 (8%) paraneoplastic syndrome, (metastatic lung, ovarian, gastric cancer, lymphoma), 12 (16%) parasitosis (strongyloidiasis, ascariasis, toxoplasmosis, trichinellosis, echinococcosis) 12 (16%) had drug-induced or postinfectious eosinophilia (reaction to lenalidomide, rituximab, phenoxymethylpenicillin, vancomycin which presented with drug rash with eosinophilia and systemic symptoms syndrome (DRESS)) and in 12 (16%) the cause remained unknown. Patients referred to the general and university hospital had similar demographic characteristics and severity but different causes of eosinophilia with the most pronounced differences in frequency of parasitosis (35% vs. 9%), allergic and autoimmune disorders (20% vs. 35%) and unknown causes (10% vs. 18%).
Conclusion
Less than 20% of patients referred to hematologic evaluation for eosinophilia have primary hematological disorders. Most have other underlying disorders, including autoimmune diseases and cancer. However, a significant proportion, especially in patients living in less urbanized areas, have parasitic infestations which must be excluded before treatment with steroids is initiated. Finally, in a significant proportion of patients the cause remains unknown, more frequently in a university hospital setting.
Session topic: 36. Quality of life, palliative care, ethics and health economics
Keyword(s): Eosinophilia
Abstract: PB2378
Type: Publication Only
Background
Eosinophilia is mostly caused by allergic or infectious disorders. Only a small proportion are primary clonal needing hematological treatment. Despite that, patients with eosinophilia are frequently referred to hematologists for diagnostic evaluation.
Aims
Analyze characteristics of patients with eosinophilia referred for hematologic evaluation in different hospital types.
Methods
Patients referred to hematologic evaluation for eosinophilia in 2016 were identified by searching electronic data bases of a general and a university hospital. Individual patient data were then extracted from their respective files.
Results
We identified 75 patients fulfilling entry criteria, 20 in the general and 55 in the university hospital. Median age was 58; 36 were male and 39 female. Seven had severe eosinophilia, 30 moderate and 38 mild eosinophilia. Ten patients (13%) had myeloid neoplasms, one with PDGFRA and one with PDGFRB rearrangement; 6 had other myeloproliferative neoplasms and 2 myelodysplasia. Twenty-three patients (31%) had allergic and autoimmune disorders (e.g. asthma, rheumatoid arthritis, polyarteritis nodosa, bullosus pemphigoid, psoriasis, coeliac disease, discoid lupus erythematosus, eosinophilic fasciitis and other), 6 (8%) paraneoplastic syndrome, (metastatic lung, ovarian, gastric cancer, lymphoma), 12 (16%) parasitosis (strongyloidiasis, ascariasis, toxoplasmosis, trichinellosis, echinococcosis) 12 (16%) had drug-induced or postinfectious eosinophilia (reaction to lenalidomide, rituximab, phenoxymethylpenicillin, vancomycin which presented with drug rash with eosinophilia and systemic symptoms syndrome (DRESS)) and in 12 (16%) the cause remained unknown. Patients referred to the general and university hospital had similar demographic characteristics and severity but different causes of eosinophilia with the most pronounced differences in frequency of parasitosis (35% vs. 9%), allergic and autoimmune disorders (20% vs. 35%) and unknown causes (10% vs. 18%).
Conclusion
Less than 20% of patients referred to hematologic evaluation for eosinophilia have primary hematological disorders. Most have other underlying disorders, including autoimmune diseases and cancer. However, a significant proportion, especially in patients living in less urbanized areas, have parasitic infestations which must be excluded before treatment with steroids is initiated. Finally, in a significant proportion of patients the cause remains unknown, more frequently in a university hospital setting.
Session topic: 36. Quality of life, palliative care, ethics and health economics
Keyword(s): Eosinophilia