Man, unlike most other animals, has a marked capacity to develop high blood eosinophil counts. This can occur in many tropical diseases especially parasitic infections and hypersensitivity reactions to a variety of antigens. In temperate climates a marked eosinophilia is more commonly due to drug reactions and tumours, but as many as a half of patients with a persistent eosinophilia may have no defined aetiology detectable. Among 80 patients with an eosinophilia seen in London, 47% were of known aetiology: 20% were due to parasitic diseases in immigrants and 21% were drug-induced. In 52% of the patients no cause could be found: 31% had ‘the hypereosinophilic syndrome’, 10% had the polyarteritis group of diseases and 7% pulmonary eosinophilia. Some of the tissue lesions seen in these syndromes, especially the cardiac and neurological damage, may be caused by products released from degranulating eosinophils. Stimulation of secretion occurs with complexes and C3b. Direct killing of isolated heart cells has been found with eosinophil secretion products and a number of cells and parasites are known to be killed by eosinophil basic protein. It is concluded that the eosinophils are prominent in many clinical settings beside parasitic diseases. The secretion of the eosinophil granule contents can have a range of effects on tissues including severe tissue injury.
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