A diagnostic protocol designed for determining allergic causes in patients with blood eosinophilia

Abstract

BackgroundBlood eosinophilia is a common laboratory abnormality, and its characterization frequently represents a quandary for primary care physicians. Consequently, in France, specialists and particularly hematologists, often must investigate patients who present with blood eosinophilia that often, but not always, occurs because of allergic causes. Both the Departments of Hematology and Parasitology at Toulouse University Hospitals established a collaboration to rule out allergic causes of eosinophilia, particularly helminthiases, prior to initiating more sophisticated investigations.MethodsSince 2004, the authors employed the same protocol to investigate eosinophilic outpatients who attended the clinic of Parasitology at Toulouse University Hospitals, and they reported the performance of this diagnostic procedure that was designed to be rapid (no hospitalization required) and only moderately expensive.ResultsA total of 406 patients who presented with blood eosinophilia greater than 0.5 (×109, giga cells per litter, G/L) had an allergic etiology in 350 (86.2%) cases. Among the remaining 56 subjects, 17 did not undergo a follow-up and 39 were referred to another specialized department, mostly Hematology. However, only 21 patients attended then were subsequently investigated. Non-allergic causes of eosinophilia, including 3 cases of the lymphoid variant of hypereosinophilic syndrome and 2 cases of myeloproliferative disorder, were identified in 14 patients, whereas 7 remained diagnosed as having idiopathic eosinophilia.ConclusionThis study underlines the need to investigate patients presenting with even moderate blood eosinophilia. The work-up that was employed appears to be efficient and versatile and may be used by any medical specialist, such as in hematology, infectious disease, or internal medicine departments, who needs to investigate eosinophilic patients and should initially rule out any etiology of allergic eosinophilia.

scFv against HSP60 of Strongyloides sp. and Its Application in the Evaluation of Parasite Frequency in the Elderly

“…If we compare this with the use of the conventional faecal test, only one individual was positive for S. stercoralis, and this same individual was among those positive for the presence of immunocomplex. Thus, we believe that these techniques complement each other, as the parasite in question has a biological cycle that includes diverse forms due to its developmental and larval stages and may be linked to haematological and allergic manifestation [22].…”

A Retrospective Study of the Efficacy of Albendazole and Diethylcarbamazine for the Treatment of Human Toxocariasis

“…At the Outpatient Clinic of the Department of Parasitology and Mycology in the Toulouse University Hospitals, France, the diagnosis of active common/covert toxocaral disease was made at the end of a meticulous protocol that has been detailed elsewhere [ 8 ]. It should be reiterated that the clinical and laboratory picture of the most frequent form of this zoonotic disease is not specific [ 1 , 7 ].…”

“…In both groups, the patients were informed at their first consultation about measures that can prevent reinfection and were urged to implement these measures [ 8 ].…”

Human toxocariasis and atopy

“…At the Outpatient Clinic of the Department of Parasitology and Mycology at Toulouse University Hospitals, France, the diagnosis of active common/covert toxocaral disease was made at the end of a meticulous protocol that has been detailed elsewhere [25]. Patients presenting with only ocular or neurological toxocariasis were not considered since the compartmentalized forms of this zoonosis result from a pathogenic process that differs from that of the generalized forms, and display a different clinical picture.…”