Abstract

Objective: Patients with persistent eosinophilia may have many conditions ranging from relatively benign diseases such as parasitic serious infections to life-threatening serious diseases. We aimed to determine the etiological causes of hypereosinophilia in children. 

Material and Methods: Patients under 18 years of age who had complete blood counts in Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital’s pediatric clinics between January 2013-January 2016 were retrospectively analyzed. Hypereosinophilia was defined as having at least two peripheral blood absolute eosinophil counts greater than or equal to 1500/mm3.The results of the examinations and diagnoses when the patients were detected with hypereosinophilia were recorded from the hospital records.

Results: Three hundred and forty patients who underwent complete blood count were found to have hypereosinophilia. Seventy patients whose file records could not be accessed were excluded from the study. Two-hundred seventy patients (56% male) with a median age of 5 (IQR:1-12) years were included in our study. When the diagnoses of patients were examined, 48 (17.8%) had allergic diseases, 21 (7.8%) had immunodeficiency, 14 (5.2%) had parasitic disease. 15 (5.5%) had tumor, 4 (1.5%) had leukemia, 2 (0.7%) had hypereosinophilic syndrome, 2 (0.7%) had adrenal insufficiency and 2 (0.7%) had burn. Ninety-nine (36.7%) patients were found to use medication for any disease (acute or chronic). As a result of the examinations performed in 63 (23.3%) patients, it was found that there was no reason to explain hypereosinophilia.

Conclusion: The number of eosinophils may increase in many conditions. The cause of increase in eosinophil may not always be found.
Further studies are needed on the long-term prognosis of these patients.

Keywords: hypereosinophilia, childhood, parasitic infections, allergic diseases, immunologic diseases

References

  1. Mejia R, Nutman TB. Evaluation and differential diagnosis of marked, persistent eosinophilia . Semin Hematol. 2012;49:149-159
  2. Bellamy GJ, Hinchliffe RF, Crawshaw KC, Finn A, Bell F. Total and differential leucocyte counts in infants at 2, 5 and 13 months of age. Clin Lab Haematol 2000;22:81-7.
  3. Florence Roufosse , Peter F Weller. Practical approach to the patient with hypereosinophilia J Allergy Clin Immunol . 2010;126(1):39-44.
  4. Ayalew Tefferi. Blood eosinophilia: a new paradigm in disease classification, diagnosis, and treatment. Mayo Clin Proc. 2005 Jan;80(1):75-83
  5. Chen YY, Khoury P, Ware JM, Holland-Thomas NC, Stoddard JL, Gurprasad S et al. Marked and persistent eosinophilia in the absence of clinical manifestation. J Allergy Clin Immunol 2014 Apr;133(4):1195-202.
  6. Valent P, Klion AD, Horny HP, Roufosse F, Gotlib J, Weller PF, et al. Contemporary consensus proposal on criteria and classification of eosinophilic disorders and related syndromes. J Allergy Clin Immunol 2012;130: 607-612.e9
  7. Schwartz JT, Fulkerson PC. An approach to the evaluation of persistent hypereosinophilia in pediatric patients. Front Immunol 2018;9:1944.
  8. Williams KW, Ware J, Abiodun A, Holland-Thomas NC, Khoury P, Klion AD. Hypereosinophilia in children and adults: a retrospective comparison. J Allergy Clin Immunol Pract 2016;4:941-947.e1
  9. Burris D, Rosenberg CE, Schwartz JT, Zhang Y, Eby MD, Abonia JP et al. Pediatric Hypereosinophilia: Characteristics, Clinical Manifestations, and Diagnoses.J Allergy Clin Immunol Pract. 2019 ;7(8):2750-2758
  10. Katz HT, Haque SJ, Hsieh FH. Pediatric hypereosinophilic syndrome (HES) differs from adult HES. J Pediatr 2005;146:134-6.
  11. Chilcote RR, Pergament E, Kretschmer R, Mikuta JC. The hypereosinophilic syndrome and lymphoblastic leukemia with extra C-group chromosome and q14þ marker. J Pediatr 1982;101:57-60.
  12. Egesten A, Hagerstrand I, Kristoffersson U, Garwicz S. Hypereosinophilic syndrome in a child mosaic for a congenital triplication of the short arm of chromosome.Br J Haematol 1997;96:369-73.
  13. Farruggia P, Giugliano E, Russo D, Trizzino A, Lorenzatti R, Santoro A, et al. FIP1L1-PDGFRalpha-positive hypereosinophilic syndrome in childhood: a case report and review of literature. J Pediatr Hem Onc 2014;36:28-30
  14. Guitard AM, Horschowski N, Mozziconacci MJ, Michel G, George F, Capodano AM, et al. Hypereosinophilic syndrome in childhood: trisomy 8 and transformation to mixed acute leukaemia. Nouv Rev Fr Hematol 1994;35:555-9
  15. Rothenberg ME, Epstein FH. Eosinophilia. New Eng J Med 1998, 388(22): 1592-1600
  16. Munzer D. New perspectives in the diagnosis of Echinococcus disease. J Clin Gastroenterol 1991;13:415-23.
  17. Aleman K, Noordzij JG, de Groot R, van Dongen JJ, Hartwig NG. Reviewing Omenn syndrome.Eur J Pediatr. 2001 Dec;160(12):718-25.
  18. Grimbacher B, Holland SM, Puck JM.Hyper-IgE syndromes. Immunol Rev. 2005;203:244-50.
  19. Orange JS, Stone KD, Turvey SE, Krzewski K. The Wiskott-Aldrich syndrome. Cell Mol Life Sci. 2004;61(18):2361–85.
  20. Navabi B, Upton JE. Primary immunodeficiencies associated with eosinophilia.Allergy Asthma Clin Immunol. 2016;24:12-27.
  21. Boyle JM, Buckley RH. Population prevalence of diagnosed primary immunodeficiency diseases in the United States. J Clin Immunol 2007;27(5):497–502
  22. Kilic SS, Ozel M, Hafizoglu D, Karaca NE, Aksu G, Kutukculer N. The prevalences and patient characteristics of primary immunodeficiency diseases in Turkey-two centers study.J Clin Immunol. 2013;33(1):74-83
  23. Criado PR, Criado RF, Avancini JM, Santi CG. Drug reaction with Eosinophilia and Systemic Symptoms (DRESS) / Drug-induced Hypersensitivity Syndrome (DIHS): a review of current concepts. An Bras Dermatol 2012;87:435-49.

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Copyright © 2021 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Külhaş Çelik İ, Büyüktiryaki B, Gültekin Açıkgöz F, Erkan MO, Guzelkucuk Z, Özbek NY, et al. Evaluation of Etiological Factors Causing Hypereosinophilia in Children. Turk J Pediatr Dis [Internet]. 2021 Sep. 23 [cited 2025 Aug. 23];15(5):373-8. Available from: https://turkjpediatrdis.org/article/view/755