Day #101 - Eosinophilia

Today we discussed a case of hypereosinophilia.

We discussed the differential diagnosis of eosinophilia including:

• Idiopathic Hypereosinophilic Syndrome (HES)
  
• Eosinophilic malignancies
• Systemic mastocytosis
  
• Associated with lymphoma (IL5 production)
  
• Infections
  
  • Parasitic (during tissue invasion): strongyloidiasis, ascariasis, hook worm, angiostronyliasis, liver flukes (fasciolysis, chlonorcis), trichenosis, filariases, paragonamiasis.
    
  • Viral: HIV
  • Fungal: Aspergillosis (especially ABPA), coccidiomycosis
    
• Allergy including asthma
  
• Medications
  
  • NSAIDS, allopurinol, phenytoid, semisynthetic penicillins, ASA
    
• Autoimmune disease
  
  • Churg-Strauss
    
• Addison's disease (usually low level)
  
• Cholesterol embolism
  

NB: from up to date: "Strongyloides can persist for decades without causing major symptoms. The infection elicits varying degrees of eosinophilia ranging from minimal to such high magnitude that it is mistaken for idiopathic hypereosinophilic syndrome."