Eosinophilic Leukemoid Reaction Research Articles

Eosinophilic leukemoid reaction in a child with mixed helminthiasis

Eosinophilic leukemoid reaction in a child with mixed helminthiasis

Токсокароз у детей: эпидемиологические, клинические и лабораторные аспекты

Aim: to optimize the diagnosis of toxocariasis based on the analysis of epidemiological, clinical and laboratory data in children with the infestation. Patients and Methods: the analysis of official statistical data for the period of 2014–2018, literature sources, a retrospective analysis of 57 medical records of patients (40 children and 17 adults) who received treatment and diagnostic in the clinic of the Rostov Research Institute of Microbiology and Parasitology of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing in 2015–2018 was conducted. Results: a decrease in the incidence of newly diagnosed infestation cases was revealed (registered in the clinic of the Rostov Research Institute of Microbiology and Parasitology of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing). It correlated with official statistics (r=0.9, p=0.05). Based on clinical and laboratory examination, the diagnosis was established in 26 patients (45.6%). Among patients with a verified diagnosis of toxocariasis, the proportion of children aged 1 years and 1 months to 10 years old, was 96%. An analysis of epidemiological data showed that 76% of children had close contact with the soil. The infestation occurred in the form of latent toxocariasis in 36% of patients. In more than half of the cases, the disease was clinically manifested by geophagy (56.0%). A permanent laboratory parameter was the eosinophilic leukemoid reaction in patients with toxocariasis. Peripheral blood eosinophilia ranged from 15.66.2±9.31% in latent toxocariasis to 25.5±15.0 % in visceral toxocariasis. The positive rate in ELISA with Toxocara antigen was higher than that in the group of patients with visceral toxocariasis. However, there was no correlation between the eosinophilia level and positive rate (r=0.1, p=0.05). Conclusion: in areas where the incidence of toxocariasis and environmental contamination with invasive helminth eggs are high, it is advisable to perform tests of the peripheral blood in children at least one time per year in the autumn for timely diagnosis of infestation. The use of ELISA with Toxocara antigen is reasonable in the cases of peripheral blood eosinophilia. KEYWORDS: toxocariasis, statistics, incidence, eosinophilia, enzyme-linked immunosorbent assay, Toxocara antigen. FOR CITATION: Andreeva A.O., Golovchenko N.V., Zhuravlev A.S. Toxocariasis in children: epidemiological, clinical and laboratory aspects. Russian Medical Inquiry. 2020;4(11):670–675. DOI: 10.32364/2587-6821-2020-4-11-670-675.

Tropical Pulmonary Eosinophilia with Eosinophilic Leukemoid Reaction

A 7 year-old male presented with recurrent fever, cough and respiratory distress for over last 2 years. Based on extremely high eosinophil count, high Immunoglobulin E, increase in eosinophilic precursors in bone marrow, and positive antigen test for Wuchereria bancrofti, a diagnosis of Tropical Pulmonary Eosinophilia with Eosinophilic Leukemoid Reaction was made. Complete recovery was achieved with Diethylcarbamazine for 3 weeks. We are reporting this case as the first case of Tropical pulmonary eosinophilia with eosinophilic leukemoid reaction in a child.

Eosinophilic leukemoid reaction in a male adolescent with Löeffler syndrome.

The Löeffler syndrome is characterized by pulmonary infiltrates on a chest x-ray accompanied with peripheral eosinophilia. In this article, we have highlighted the Löeffler syndrome complicated with a eosinophilic leukemoid reaction in a previously healthy boy. The patient was treated with albendazole for five days, with a successful result. In countries where parasitic diseases are endemic, the Löeffler syndrome must always be considered in patients who present with a eosinophilic leukemoid reaction.

Rapid onset lung squamous cell carcinoma with prominent peritoneal carcinomatosis and an eosinophilic leukemoid reaction, with coexistence of the BRAF V600E and oncogenic KRAS G12A mutations: A case report.

Peritoneal carcinomatosis from lung cancer is rare, particularly from lung squamous cell carcinoma (LSCC). Concurrent somatic BRAF and KRAS mutations within the same tumor specimen have not been reported. The present study describes the case of a treatment-naïve LSCC patient with coexisting BRAF V600E and oncogenic KRAS G12A mutations in the primary lung lesion and the peritoneal metastases. The patient presented with prominent peritoneal carcinomatosis and an eosinophilic leukemoid reaction, but no respiratory symptoms. The patient succumbed 8 days after the onset of the condition due to rapid aggravation of the peritoneal carcinomatosis. To the best of our knowledge, this is the first study concerning the coexistence of BRAF and KRAS mutations in LSCC. Intensive activation of ERK was also observed in the primary lung lesion and the peritoneal metastases. Although the exact pathogenesis was unclear, the observations indicated that in the present study, the BRAF V600E and KRAS G12A mutations may have cooperate in inducing the malignant phenotype of LSCC. This case also highlighted the potential aggressive course and unusual pattern of spread of this specific dual-mutated tumor.

Acute eosinophilic pneumonia with eosinophilic leukemoid reaction: a rare hematologic presentation.

Sir, A 26-year-old man presented to us with chief complaints of fever, cough, and dyspnea since 15 days. There was no history of hemoptysis, chest pain, orthopnea, palpitations, or edema feet. A more detailed history was negative for environmental or medication exposure. Past history was insignificant for any prolonged illness. There was no history of any addiction. On examination, pulse was 100/min, regular. Respiratory rate was 18/min, and the temperature was 38.6 °C. JVP was not raised. Auscultation of the lungs revealed bilateral, diffuse rales. Cardiovascular system examination was normal. Investigations revealed, Hb of 11 g %, Total leucocyte count (TLC) was 52,000, DLC revealed polymorphs of 15 %, eosinophils 78 %, lymphocytes 6 %, monocyte 1 % (Fig. 1). Peripheral smear was devoid of any blasts. Absolute eosinophil count was 38,000/mm3 (normal 52–250 mm3). Platelet count was 250,000/mm3. The bone marrow aspiration revealed eosinophilic proliferation without any blasts (Fig. 2). The blood biochemistry was normal. CXR revealed bilateral haziness. HRCT of thorax revealed bilateral ground glass opacities (GGOs) (Figs. 3, ​,4).4). Two dimensional (2D) echo was normal. ABG revealed partial pressure of oxygen, 68 mmHg; partial pressure of carbon dioxide, 29 mmHg; and pH, 7.50. SpO2 was 84 % while patient was breathing ambient air. Cultures of sputum, blood, and urine were negative for bacteria, mycobacteria, fungi. ESR was 24 mm in first hour. Peripheral smear examination for parasites and microfilaria was negative. Fig. 1 Peripheral smear (Leishman stained ×10 view) showing eosinophilia Fig. 2 Bone marrow slide (Leishman stained ×40 view) showing eosinophilic predominance Fig. 3 Coronal CT image shows bilateral, diffuse and patchy ground glass opacity (arrows) Fig. 4 Axial CT image showing bilateral ground glass opacity Patient was treated with empirical antibiotics, NIPPV, oral corticosteroids (Tab. prednisolone 60 mg/day). Patient’s breathlessness decreased dramatically on the third day. NIPPV was discontinued. He was maintaining O2 saturation of 98 % in ambient air. ABG became normal. A bronchoalveolar lavage was done, which revealed, total cell count of 132 × 103 with 22 % eosinophils. In the first week after treatment TLC came down to 15,000/mm3, with 25 % eosinophils. AEC was 4,000/mm3. Repeat HRCT showed partial clearing of the GGOs. Fever, cough and dyspnea subsided. A diagnosis of acute eosinophilic pneumonia with eosinophilic leukemoid reaction was made. By the end of second week, TLC was 10,000/mm3. DLC revealed 12 % eosinophils. AEC was 1,100/mm3. Patient was discharged with a tapering dose of prednisolone, and was advised follow up after two weeks.

Trichuris dysentery syndrome with eosinophilic leukemoid reaction mimicking inflammatory bowel disease

Trichuris dysentery syndrome with eosinophilic leukemoid reaction mimicking inflammatory bowel disease

Eosinophilic Leukemoid Reaction in a Woman with Spindle Cell Sarcoma of the Leg

Eosinophilic Leukemoid Reaction in a Woman with Spindle Cell Sarcoma of the Leg

Eosinophilic leukemoid reaction associated with carbamazepine hypersensitivity

Carbamazepine is widely used in the treatment of epilepsy, neuralgic pain, and bipolar affective disorders. Several adverse drug reactions have been described during the course of carbamazepine administration, including exanthemata and hematological reactions. Carbamazepine is one of the common drugs that have been implicated in the etiology of drug hypersensitivity syndrome. A 50-year-old male presented with generalized erythroderma following 10 weeks of ingestion of carbamazepine 200 mg daily for idiopathic epilepsy. His systemic examination was within normal limits. Blood counts revealed marked eosinophilia of 52% (absolute eosinophil count of 10,400 per mm3). Bone marrow aspiration revealed a moderate increase in the eosinophilic series with cells showing normal morphology. The eosinophil counts returned to normal after 2 weeks of oral prednisolone therapy. This case is reported because of its rarity in the Indian medical literature.

Síndrome hipereosinofílica idiopática associada à doença eosinofílica disseminada em um cão

Relata-se um caso de síndrome hipereosinofílica idiopática associada à doença eosinofílica disseminada em um cão, macho, mestiço Pastor Alemão, com cinco anos de idade. Os sinais clínicos incluíam apatia, anorexia, intolerância ao exercício, caquexia, dispnéia e taquicardia. Laboratorialmente, havia reação leucemóide eosinofílica e na citologia da medula óssea observou-se acentuada hiperplasia eosinofílica. Radiologicamente, detectou-se uma área radiopaca intratorácica bilateral cranial ao coração. A punção aspirativa intratorácica demonstrou grande quantidade de eosinófilos, o que permitiu um diagnóstico clínico de infiltração pulmonar com eosinofilia. O diagnóstico foi confirmado histologicamente.

Cytokines in Inflammatory Malignant Fibrous Histiocytoma Presenting With Leukemoid Reaction

Inflammatory malignant fibrous histiocytomas (IMFH) are rare tumors and are frequently associated with leukocytosis. In rare cases, leukemoid reactions were attributed to tumor production of unidentified hematopoietic factors. In this study, we used immunohistochemical techniques to show cytokine immunoreactivity in the malignant cells of two cases of IMFH presenting with leukemoid reactions and compared them with two malignant fibrous histocytomas, noninflammatory type. All four tumors stained positively for stem cell factor (SCF), granulocyte colony-stimulating factor (G-CSF), interleukin-2 (IL-2), IL-4, IL-5, interferon-alpha (IFN-alpha), and insulin-like growth factor-I. Other cytokines detected only in the two IMFH included IL-6, IL-7, IL-8, IFN-gamma, and keratinocyte growth factor. Granulocyte-macrophage-CSF, IL-3, and transforming growth factor-beta staining was present in one of the two IMFH tumors and was not present in the noninflammatory tumors. The immunohistochemical staining was localized to the malignant cells, suggesting deregulated cytokine expression consistent with their monocytic/histocytic origin. Expression of certain cytokines in the IMFH may account for the local inflammatory infiltrate, tumor fibrosis, and the aggressive nature of the malignant cells. We also detected elevated serum levels of SCF, G-CSF, IL-6, and tumor necrosis factor in one or both of the IMFH patients. These latter observations may explain the bone marrow hypercellularity and other paraneoplastic symptoms, including fever, malaise, and weight loss, observed in both patients. Different cytokines present in the two IMFH tumors appear to be responsible for the eosinophilic leukemoid reaction observed in one case and for the granulocytic leukemoid reaction observed in the other patient. They may also be responsible for expansion of the tumor-cell population, fibroblast proliferation, and enhanced secretion of extracellular collagen.

Cytokines in inflammatory malignant fibrous histiocytoma presenting with leukemoid reaction

Inflammatory malignant fibrous histiocytomas (IMFH) are rare tumors and are frequently associated with leukocytosis. In rare cases, leukemoid reactions were attributed to tumor production of unidentified hematopoietic factors. In this study, we used immunohistochemical techniques to show cytokine immunoreactivity in the malignant cells of two cases of IMFH presenting with leukemoid reactions and compared them with two malignant fibrous histocytomas, noninflammatory type. All four tumors stained positively for stem cell factor (SCF), granulocyte colony-stimulating factor (G-CSF), interleukin-2 (IL-2), IL-4, IL-5, interferon-alpha (IFN-alpha), and insulin-like growth factor-I. Other cytokines detected only in the two IMFH included IL-6, IL-7, IL-8, IFN- gamma, and keratinocyte growth factor. Granulocyte-macrophage-CSF, IL- 3, and transforming growth factor-beta staining was present in one of the two IMFH tumors and was not present in the noninflammatory tumors. The immunohistochemical staining was localized to the malignant cells, suggesting deregulated cytokine expression consistent with their monocytic/histocytic origin. Expression of certain cytokines in the IMFH may account for the local inflammatory infiltrate, tumor fibrosis, and the aggressive nature of the malignant cells. We also detected elevated serum levels of SCF, G-CSF, IL-6, and tumor necrosis factor in one or both of the IMFH patients. These latter observations may explain the bone marrow hypercellularity and other paraneoplastic symptoms, including fever, malaise, and weight loss, observed in both patients. Different cytokines present in the two IMFH tumors appear to be responsible for the eosinophilic leukemoid reaction observed in one case and for the granulocytic leukemoid reaction observed in the other patient. They may also be responsible for expansion of the tumor-cell population, fibroblast proliferation, and enhanced secretion of extracellular collagen.

Hypereosinophilic Syndrome with a Rapidly Fatal Course in a Saudi Child

Hypereosinophilic Syndrome with a Rapidly Fatal Course in a Saudi Child

A Case of Eosinophilia with Bronchoalveolar Cell Carcinoma of Lung

The solid and hematologic cancer are occasionally accompanied by peripheral blood eosinophilia and suggest tumor necrosis or wide dissemination, but the mechanisms underlying this curious relationship remain obscure. The association of this eosinophilic leukemoid reaction with carcinoma seems to occur must frequently with bronchogenic carcinoma. Several mechanisms for this association were considered: eosinophil chemotactic factor, eosinophilia mediated by T-lymphocyte, and eosinopoietic hormone. we are here reporting a case of bronchoalveolar cell carcinoma of lung associated with peripheral eosinophilia in a 60-year-old male patient.

Réaction éosinophile leucémoïde au cours d'une adénopathie angio-immunoblastique

A case of eosinophilic leukemoid reaction is described. This picture is seldom encountered during the course of angio-immunoblastic adenopathy. After reviewing various diagnoses and pointing out similar cases of the literature, the authors discuss the possible pathophysiologic mechanisms of eosinophilia in this disorder.

ACUTE UNDIFFERENTIATED LEUKEMIA WITH EOSINOPHILIA IN A CHILD

A case of acute undifferentiated leukemia in an 8-year-old child is reported. The presenting feature of the disease was a marked peripheral eosinophilia (80%) with immature and somewhat atypical eosinophils. The bone marrow showed prevalence of large blast cells with scarce basophilic cytoplasm and one or more nucleoli. The rate of eosinophils was increased. The presence of parasitic infections or allergic diseases was excluded. Two short term remissions were obtained. No eosinophilia was observed during the subsequent relapses. Death ensued after 17 months.Differential diagnosis with the eosinophilic leukemia, the hypereosinophilic syndromes and the eosinophilic leukemoid reaction is done. The significance of marked eosinophilia in acute leukemia is discussed, mainly aa an initial response to some still poorly defined antigenic stimulus of the leukemic cells. Its relationship to the so called tumor associated eosinophilic factor is aloo taken into account.

Eosinophilic leukemoid reaction: Report of a case, its relationship to eosinophilic leukemia, and review of the pediatric literature

The very existence of eosinophilic leukemia remains a controversial issue. Although several recent reviews have attempted to establish criteria for the diagnosis, there are few, if any, obvious cases in the pediatric literature. The case reported here adds another dimension to the spectrum of disorders called eosinophilic leukemia. Alternative explanations are offered for the courses of previously reported cases in children. Additional information regarding eosinophil migration and factors mediating eosinophilia is reviewed, and more strict criteria for establishing the diagnosis of eosinophilic leukemia are suggested.

Extensive pseudomonal pneumonia ultimately responding to polymyxin therapy.

Extensive pseudomonal pneumonia developed in a 43-year-old white man after therapy for pneumococcal pneumonia with penicillin, kanamycin, and positive pressure breathing. The pneumonic process involved all five lobes and was accompanied by bilateral cavity formation and pleural effusions. Recovery occurred with conservative medical management over a prolonged period. The patient's clinical course was marked by the development of an eosinophilic leukemoid reaction, presumably secondary to polymyxin therapy. In the few successfully treated patients with pseudomonal pneumonia described, minimal chronic roentgenographic changes occurred in those who responded to therapy. Prognosis in patients with underlying chronic lung disease would appear to be unusually poor.