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ISSN: 1426-3912
Central European Journal of Immunology
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vol. 49
Review paper

The challenge of diagnosing and classifying eosinophilia and eosinophil disorders: A review

Agnieszka Szymczyk
Jakub Jaworski
Monika Podhorecka

  1. Department of Hematology, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland
  2. Doctoral School, Medical University of Lublin, Poland
  3. Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Poland
Cent Eur J Immunol 2024; 49 (1): 60-69
Online publish date: 2024/04/19
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Eosinophilia is a feature of multiple conditions, both hematologic and non-hematologic, and may be associated with organ damage. The pathogenesis of eosinophilia can follow two distinct pathways. Primary eosinophilia is caused by a cell-intrinsic mechanism originating from clonal expansion of eosinophils through acquisition of a somatic mutation, such as FIP1L1-PDGFRA. In recent years, great progress has been made in the field of pathogenesis and molecularly targeted therapy of neoplastic eosinophilia. The diagnostic procedure should include, among other things, morphologic analysis of blood and bone marrow samples, cytogenetics and fluorescence in situ-hybridization tests to detect evidence of an acute or chronic myeloid or lymphoid disorder. Secondary eosinophilia follows a cell-extrinsic mechanism as a response to exogenous cytokines. In most clinical cases, peripheral blood eosinophilia is reactive and typically associated with non-hematological disorders such as infections, allergic conditions, connective tissue disorders, vasculitis, malignancy, or endocrinopathies. Nonetheless, the cause of most cases of hypereosinophilic syndrome remains unknown. In this article, we present a short review focused on differential diagnosis of eosinophilia and eosinophilic disorders. The diagnosis of eosinophilia is a challenge for physicians; thus this review may be useful in clinical practice.

eosinophilia, FIP1L1-PDGFRA, hypereosinophilic syndrome, chronic eosinophilic leukemia

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