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PatientPlus articles are written for doctors and so the language can be technical. However, some people find that they add depth to the articles found in the other sections of this website which are written for non-medical people.

Eosinophilia

Eosinophilia is defined as a peripheral eosinophil count is greater than 0.44 x 109/l. In many cases the cause is clear, e.g. atopic disease. However the differential diagnosis includes many more serious diseases, including malignancy.

Epidemiology
  • In the UK, eosinophilia is most often due to allergic conditions.
  • Worldwide, helminth infections are the most common cause of eosinophilia.
Presentation
  • Travel history to assess whether a patient has travelled to an area that is endemic for certain infections, including helminthic infections.
  • Medication and diet history to evaluate for allergic reactions associated with eosinophilia.
  • History of symptoms associated with possible underlying causes (see below).
  • A history suggestive of adrenal insufficiency, including the use and tapering of corticosteroid medications, can provide a clue that the observed eosinophilia is associated with adrenal insufficiency.
  • A complete physical examination is required because diseases associated with eosinophilia can involve any part of the body.
Differential diagnosis
Investigations
  • Full blood count, including differential white cell count.
  • Lumbar puncture: CSF eosinophilia due to worm infections (e.g. Angiostrongylus cantonensis), drug reactions, and coccidioidomycosis fungal meningitis.
  • CT scans of the lungs, abdomen, pelvis, and brain evaluate for focal defects due to diverse causes of eosinophilia, e.g.:
    • Worm infections of the liver (e.g. Fasciola hepatica) can cause focal hepatic lesions.
    • Coccidioidomycosis fungal infection can cause focal lesions in the lung, which are visible on a chest x-ray or CT scan.
    • Hodgkin or non-Hodgkin lymphoma can cause lymphadenopathy in the abdomen, which can be seen on a CT scan.
  • Echocardiogram to assess for thrombi (e.g. mural, endocardial) due to Hypereosinophilic syndrome
  • Cystoscopy: all patients with blood eosinophilia and haematuria and who have been in Africa should have their urine examined for the eggs of Schistosoma haematobium. Cystoscopy may be required to confirm the diagnosis.


Internet and further reading
  • Lucey DR; Eosinophilia; eMedicine; February 2002
  • Peter Weller; Oxford Textbook of Medicine 4th edition; Section 22.35.
Acknowledgements EMIS is grateful to Dr Colin Tidy for writing this article. The final copy has passed scrutiny by the independent Mentor GP reviewing team. ©EMIS 2008.
DocID: 2100
Document Version: 22
DocRef: bgp24893
Last Updated: 19 Jul 2007
Review Date: 18 Jul 2009
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PS - Health and Poverty

Perhaps the biggest cause of ill health in the world is poverty. Help to Make Poverty History. For example, why not lend some of your money to disadvantaged communities to enable them to trade their way out of poverty through schemes such as Shared Interest.

See also MAKEPOVERTYHISTORY North East for details and links to campaigns against poverty.

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