Hypereosinophilic syndrome: Clinical, laboratory, and imaging manifestations in patients with hepatic involvement

Abstract Background. In the last years an uprising interest for a relatively unknown entity, eosinophilic ascites (EA), has been recorded. Our aim is to investigate the potential causes of EA development, as well as clinical, laboratory, endoscopic and radiologic features, management and outcome in these patients. Methods. The following research was performed on PubMed (MEDLINE) database using the medical subject headings [Mesh] terms “Ascites” AND “Eosinophils”. Results. A total of 284 results, dating from 1962 onwards, were found and abstracts were examined. 131 papers were excluded and the remaining 153 publications, consisting in case reports and series of cases, were analyzed. From 171 patients with EA, 127 subjects (74%) had EGE, 17 (10%) parasitic and fungal infections, 11(7%) Hypereosinophilic syndrome and 16 patients (9%) less common diseases (eosinophilic pancreatitis, chronic eosinophilic leukemia, myelofibrosis, T-cell lymphoma, Churg Strauss Syndrome, Systemic lupus erythematosus, Familial paroxysmal polyserositis and Ménétrier’s disease). High eosinophil blood count and IgE levels as well as gastrointestinal symptoms are frequent. The diagnosis is based on ascitic fluid analysis, imaging and endoscopic biopsies. Therapy with corticosteroids results in resolution of eosinophilic ascites in almost all patients. Conclusion. In most cases, in the absence of allergy, parasitic infections, malignancy, hematological disorders, peritoneal tuberculosis, inflammatory bowel disease or autoimmune disease, EA develops as a manifestation of eosinophilic gastroenteritis.

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Hepatic involvement in hypereosinophilic syndrome: value of portal venous phase imaging

Abdominal Imaging ◽

10.1007/s002619900310 ◽

1998 ◽

Vol 23 (2) ◽

pp. 154-157 ◽

Cited By ~ 14

Author(s):

S. H. Cha ◽

C. M. Park ◽

I. H. Cha ◽

H. J. Kim ◽

D. H. Lee ◽

...

Keyword(s):

Hypereosinophilic Syndrome ◽

Phase Imaging ◽

Portal Venous Phase ◽

Hepatic Involvement ◽

Venous Phase

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Clinical, laboratory and therapeutic aspects of canine idiopathic hypereosinophilic syndrome: case report

Acta Veterinaria Brasilica ◽

10.21708/avb.2018.12.3.7667 ◽

2018 ◽

Vol 12 (3) ◽

pp. 76-83

Author(s):

Alessandra Moreira da Silva ◽

Mirlla Baracho Ferreira ◽

Keylla Suellen Batalha Rocha Fernandes ◽

Kayana Cunha Marques ◽

Brizza Zorayd Luz Lopes Rocha ◽

...

Keyword(s):

Case Report ◽

Clinical Laboratory ◽

Hypereosinophilic Syndrome ◽

Idiopathic Hypereosinophilic Syndrome

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Hypereosinophilic Syndrome with Hepatic Involvement in a Young Child

Journal of the Korean Radiological Society ◽

10.3348/jkrs.2003.49.3.217 ◽

2003 ◽

Vol 49 (3) ◽

pp. 217

Author(s):

Mi Ran Jung ◽

Hyun Woo Goo ◽

Seong Sook Hong ◽

Chong Hyun Yoon

Keyword(s):

Young Child ◽

Hypereosinophilic Syndrome ◽

Hepatic Involvement

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Eosinophilic pancreatitis versus pancreatitis associated with eosinophilic gastroenteritis – a systematic review regarding clinical features and diagnosis

Romanian Journal of Internal Medicine ◽

10.2478/rjim-2019-0012 ◽

2019 ◽

Vol 57 (4) ◽

pp. 284-295 ◽

Cited By ~ 1

Author(s):

Larisa Pinte ◽

Cristian Băicuș

Keyword(s):

Clinical Laboratory ◽

Case Reports ◽

Hypereosinophilic Syndrome ◽

Case Series ◽

Eosinophilic Gastroenteritis ◽

Eosinophil Infiltration ◽

Imaging Features ◽

Adequate Treatment ◽

Invasive Approach ◽

Significant Difference

Abstract Background. Over the past years, eosinophil infiltration involving the gastrointestinal tract and pancreas leading to eosinophilic pancreatitis, eosinophilic gastroenteritis and hypereosinophilic syndrome has been reported in the literature. We aimed to analyze and compare the features involving patients with eosinophilic pancreatitis and pancreatitis associated with eosinophilic gastroenteritis and to determine if there is a connection between the two disorders or if they in fact meet the diagnostic criteria for hypereosinophilic syndrome. Material and methods. The following search was performed in March 2019 on PubMed (MEDLINE) database using the medical terms “pancreatitis”, “eosinophilic pancreatitis”, “eosinophilic gastroenteritis” and “hypereosinophilic syndrome”. Results. The search revealed 119 publications from 1970 onwards. A total of 83 papers were excluded, and the remaining 36 publications, consisting in case reports and case series, were analyzed. From 45 patients, 20 subjects with eosinophilic gastroenteritis developed pancreatitis, 20/45 had eosinophilic pancreatitis, and 5/45 hypereosinophilic syndrome involving the pancreas. There was no significant difference regarding clinical, laboratory and imaging features between the three groups, despite the multiple theories that explain the association of pancreatic and gastrointestinal eosinophilic infiltration. Although there was a strong resemblance between the three groups, histological evidence of eosinophilic gastrointestinal infiltration guided the treatment towards a less invasive way, while subjects with eosinophilic pancreatitis underwent pancreatic surgery to exclude potentially malignant lesions. Conclusion. Although there are various theories that explain pancreatitis development in patients with eosinophilic gastroenteritis, hypereosinophilia diagnostic work-up should be taken into account in all patients with high number of blood eosinophils, even in those with eosinophilic pancreatitis in order to establish the diagnosis using a minimally invasive approach and to apply an adequate treatment.

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