Eosinophil activation markers in clonal and non-clonal eosinophilia

Abstract

Eosinophils are leukocytes with multiple functions in physiologic and pathologic circumstances. Eosinophilia is typically associated with reactive conditions (helmintic infections, allergic or drug reactions and atopic disorders) and sometimes with hematologic and non-hematologic malignancies. Evaluation of a patient with eosinophilia requires numerous imaging investigations and laboratory tests (19.55 vs. 4.93 ng/mL, p<0.05). Within patients with eosinophilia, the clonal eosinophilia group showed a significantly higher median ECP value compared to the median ECP values of the non-clonal eosinophilia groups -(30.15 vs. 19.5 ng/mL, p<0.05 and respectively 30.15 vs. 13.3 ng/mL, p<0.05). Also patients having non-clonal eosinophilia with malignancy had a significantly higher median ECP value compared to those of reactive eosinophilia and inflammation (19.5 vs. 13.3 ng/mL, p<0.05

Eosinophilic disorders: evaluation of current classification and diagnostic criteria, proposal of a practical diagnostic algorithm

“…Inconsistent correlation between severity of blood hypereosinophilia and clinical picture of eosinophilic disorders has been reported in the literature, since tissue eosinophilia may persist and induce organ dysfunction despite lowering the blood eosinophilia. Recent research suggests that serum eosinophil cationic protein (ECP) may prove to be a useful serological marker of eosinophil activation, which may account for these discrepancies, but further research for confirmation of diagnostic value of ECP in eosinophilic disorders is needed [11 ].…”

Persistent blood eosinophilia and eosinophil activation marker in a severe case of eosinophilic gastroenteritis associated with multiple food allergies

“…We refer to an interesting paper published in your journal about eosinophil activation markers in clonal and non-clonal eosinophilia and we aim to add some correlations between clinical and laboratory parameters in a rare eosinophilic gastrointestinal disorder [1]. Blood eosinophilia is a frequent condition in medical practice, due to a broad spectrum of diseases, usually reactive to allergies, parasitic infections, malignancies or autoimmune diseases and more rarely primary or idiopathic.…”

“…The clinical presentation of EGE may vary depending on the main segment affected and on depth and extent of bowel wall involvement. The underlining mechanism of EGE is Letter to the Editor eosinophilic infiltration and degranulation, with release of toxic mediators, such as eosinophil cationic protein (ECP), which was proposed as eosinophil activation marker and discriminatory tool for different types of eosinophilic disorders [1]. Peripheral blood eosinophilia is found in up to 80% of EGE cases and may have very high levels in serosal forms [4].…”

“…The clinical outcome after two months was good, with persistence of minimal gastrointestinal symptoms whereas hematologic control showed significant decrease of blood eosinophilia to 1430/uL, increase of serum protein, calcium and 25-OH vitamin D up to normal values, but ECP remained almost unchanged. We took into consideration the conclusions of the paper already mentioned [1], regarding the discriminatory role of ECP between clonal and reactive types of eosinophilia, with higher ECP serum levels in clonal eosinophilia and also the possibility of associated primary and reactive eosinophilia. We performed bone marrow examination, which showed reactive eosinophilia, with no blasts or atypic cells and we determined the genetic mutation platelet-derived growth factor receptor alpha -PDGFRA/ fibroblast growth factor receptor 1-FGFR1 (F/P) characteristic for myeloproliferative subtype of primary hypereosinophilic syndrome (HES), which was negative.…”