Eosinophilia hematology

Hypereosinophilia and Hypereosinophilic Syndrome

• Secondary Hypereosinophilic Syndrome
• Clinically Relevant HES Variants
• When to

suspect underlying hematologic ... Syndrome #HES #Hematology ... #eosinophilia # ... eosinophils #diagnosis

Hypereosinophilia Syndrome (HES) - Diagnosis and Management
Definition: An absolute eosinophil count (AEC) greater than 1500 and

Definition: An absolute eosinophil ... attributable to eosinophilia ... confirmed tissue eosinophilia ... with blood eosinophilia ... #diagnosis #hematology

Causes of Eosinophilia - Differential Diagnosis
Bugs:
- Fungus (aspergillosis)
- Viral (HIV)
- Ectoparasites (scabies, myiasis)

Causes of Eosinophilia ... DRESS - AIN - Eosinophilic ... Syndrome - Chronic Eosinophilic ... coyefish379 #Eosinophilia ... Diagnosis #Causes #hematology

Eosinophil Disorders Testing Algorithm
INDICATIONS FOR TESTING:
• Peripheral blood eosinophilia/hypereosinophilia uncovered incidentally during medical evaluation or

Eosinophil Disorders ... Peripheral blood eosinophilia ... specific symptoms • Eosinophilia ... Differential #diagnosis #hematology ... #eosinophilia

Diseases that mimic hematologic manifestations of IgG4-RD (lymphadenopathy, eosinophilia and polyclonal hypergammaglobulinemia).

#IgG4 #Disease #Mimics #Diagnosis #Hematology

Diseases that mimic hematologic ... lymphadenopathy, eosinophilia ... Mimics #Diagnosis #Hematology

Peripheral blood eosinophils, Phase contrast microscopy, time lapse, 100x |Olympus CH30|

Carlos Martínez Figueroa @CarlosMartnezF7

#eosinophils #Peripheral #blood

Peripheral blood eosinophils ... CarlosMartnezF7 #eosinophils ... clinical #microscopy #hematology

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Eosinophilic Gastroenteritis: Treatment Options Based on Severity of the Disease
Mild:
• Trial of PPI
• Trial

Eosinophilic Gastroenteritis ... Concern for HES: • Hematology ... scan #EoE #Eosinophilic

Causes of Leukocytosis and Leukopenia - Differential Diagnosis
• Eosinophilia (AEC > 500, hypereosinophilia > 1500):

Diagnosis • Eosinophilia ... Diagnosis #causes #hematology

Approach to Elevated Tryptase - Differential Diagnosis Framework

The DDx of elevated tryptase can be broken down

ESRD & CAD • Eosinophilic ... Mastocytosis • Other hematologic ... Differential #Diagnosis #hematology

ANCA-Associated Vasculitis
There are many definitions, but most come down to the presence of granulomas (pathologically or

clinically) and asthma/eosinophils ... No Asthma and Eosinophilia ... Both asthma and eosinophilia ... and/or 10%) - Eosinophilic ... diagnosis #algorithm #rheumatology

Eosinophilic Pneumonia
When to suspect Eosinophilic Pneumonia? Non-resolving pneumonia + BAL > 25% eosinophils + excluded more

Eosinophilic Pneumonia ... When to suspect Eosinophilic ... pneumonia + BAL > 25% eosinophils ... diagnoses Acute Eosinophilic ... Rare Peripheral Eosinophilia

Eosinophilic meningitis
#eosinophilicmeningitis #eosmeningitis #angiostrongylus #baylisascaris #gnathostoma #raccoon #snail

By Dr. Sara Dong @swinndong via Febrile [febrilepodcast.com

Eosinophilic meningitis ... Ddx #Diagnosis #eosinophilia ... #eosinophil #fever

Eosinophilia - Differential Diagnosis Algorithm
Idiopathic Eosinophilia
Primary Eosinophilia:
• Primary hypereosinophilic syndrome
• Eosinophilic Leukemia
• MPN/MDS

Eosinophilia - Differential ... Algorithm Idiopathic Eosinophilia ... Primary Eosinophilia ... • MPN/MDS w/ eosinophilia ... Secondary Eosinophilia

On the left a case of chronic eosinophilic pneumonia.
It was a patient with low-grade fever, progressive

case of chronic eosinophilic ... There was a marked eosinophilia ... Chronic eosinophilic ... Chronic eosinophilic ... increased number of eosinophils

Causes of Knee Effusions - Differential Diagnosis Framework

Knee Effusion Red Flags:
1. Fever/Chills/Joint pain/Night sweats/Weight loss
- DDX:
-

Effusions: - Hematologic ... Osteosarcoma - Eosinophils ... Osteochondroma Hematologic

Infectious causes of eosinophilia

By Dr. Hawra Al-Lawati @hawraallawati via Febrile [febrilepodcast.com]
#ID #Infectious Diseases #Infections
#Differential

Infectious causes of eosinophilia ... Ddx #Diagnosis #eosinophilia ... #eosinophil #fever

Differential Diagnosis of Pulmonary Eosinophilia
Infection:
• Helminthic: Loffler syndrome (Ascaris, hookworm, Strongyloides), Tropical pulmonary eosinophilia (lymphatic

Diagnosis of Pulmonary Eosinophilia ... Tropical pulmonary eosinophilia ... sting Others: • Eosinophilic ... chronic pulmonary eosinophilia ... Questions @WuidQ #Eosinophilia

Paraproteinemias

Entities That Can Feature A Monoclonal Protein/M Component:
• MM
• WM
• MGUS
• MGCS
• MGRS
• Splenic Marginal Zone

Episodic angioedema+eosinophilia ... Paraproteinemias #Hematology

Biologic therapy for eosinophilic asthma
• Mepolizumab (Nucala)
• Anti-lL-5, 100 mg SQ q4

Biologic therapy for eosinophilic ... • Peripheral eosinophils ... • Peripheral eosinophils ... • Peripheral eosinophils ... • Peripheral eosinophils

Eosinophilic esophagitis management algorithm according to available consensus guidelines and expert recommendations. EGD=esophagogastroduodenoscopy; PPI=proton pump inhibitor;

Eosinophilic esophagitis ... EosinophilicEsophagitis #Eosinophilia

Eosinophilic Esophagitis (EoE) - Spectrum of Response
Non-response:
• Histology: Persistent eosinophilia, ≥ 15 eos/hpf
• Symptoms:

Eosinophilic Esophagitis ... Histology: Persistent eosinophilia ... Histology: Reduced eosinophilia ... score < 2 #Eosinophilic

ANCA Vasculitis - GPA, MPA, Eosinophilic GPA

doi:10.1038/s41572-020-0204-y

#ANCA #Vasculitis #GPA #MPA #Eosinophilic #rheumatology #diagnosis #comparison #table

Vasculitis - GPA, MPA, Eosinophilic ... Vasculitis #GPA #MPA #Eosinophilic ... #rheumatology #

Aplastic Anemia - Overview

Who?
• M = F
• 3 peaks: 1) Childhood 2) 15-25 years 3) >60 years

What?
• Aplastic anemia

- Hepatitis, eosinophilic ... Anemia #oncology #hematology

2021 ACR/VF Guidelines for Management of Eosinophilic Granulomatosis with Polyangiitis (EGPA)

#EGPA #Eosinophilic #Granulomatosis #Polyangiitis #ACR2021 #Management

Management of Eosinophilic ... (EGPA) #EGPA #Eosinophilic ... ACR2021 #Management #rheumatology

Approach to Eosinophilic Lung Diseases
• Acute Eosinophilic Pneumonia (< 1 wk) - ~30yo, M; Recent

Approach to Eosinophilic ... Diseases • Acute Eosinophilic ... SOB • Chronic Eosinophilic ... fever, rhinitis • Eosinophilic ... BCM_InternalMed #Eosinophilic

Drug Reaction with Eosinophilia and Systemic Signs (DRESS Syndrome): Formerly known as drug hypersensitivity reaction, DRESS
represents

Reaction with Eosinophilia ... Images #Clinical #Dermatology ... #DrugReaction #Eosinophilia

Algorithmic Approach to Acute Interstitial Nephritis
When to suspect AIN? (not sensitive)
• AKI, AKD, rapidly progressive

: fever, rash, eosinophilia ... pyuria, WBC casts, eosinophiluria

Small Vessel Vasculitides
• Granulomatosis with polyangiitis - Granulomatous manifestations (e.g., nasal crusting, destructive sinusitis, pulmonary

lung disease • Eosinophilic ... polyangiitis - Asthma. eosinophilia

Leukemias Overview: ALL, CML, AML, APML, CLL

Acute leukemias > 20% blasts in the peripheral blood smear

• (Peripheral eosinophilia ... #Leukemia #Hematology

Eosinophilic Pneumonia - Diagnosis and Presentation

• Acute Eosinophilic Pneumonia
• Chronic Eosinophilic Pneumonia

Andrew

Eosinophilic Pneumonia ... Presentation • Acute Eosinophilic ... Pneumonia • Chronic Eosinophilic ... ASanchez_PS #Eosinophilic

Causes of Neutropenia with Pancytopenia - Differential Diagnosis Algorithm
Sequestration:
• Splenomegaly
Marrow Infiltration:
• Hematologic and non-hematologic

Infiltration: • Hematologic ... and non-hematologic ... Algorithm #Causes #Hematology

Thrombotic Microangiopathies In Systemic Lupus Erythematosus

Dr. Laurent ARNAUD @Lupusreference

#TMAs #Thrombotic #Microangiopathies #Systemic #Lupus #Erythematosus #SLE #hematology

Erythematosus #SLE #hematology ... #rheumatology #

Summary of haemotology cell lineages and the malignancies associated with them. Visit gramproject.com for more medical

Summary of haemotology ... #algorithm #hematology

Skin Conditions Associated with Joint Pain

Rash
• Human parvovirus B19 infection

Malar rash
• SLE
• Human parvovirus B19 infection
•

Amyloidosis • Eosinophilic ... Sarcoidosis #dermatology ... differential #diagnosis #rheumatology

Vasculitis Management - ACR/VF 2021 Guidelines for Treatment & Management
• Giant Cell Arteritis (GCA)
•

Polyangiitis (MPA) • Eosinophilic ... Guidelines #algorithm #rheumatology

Eosinophilic Granulomatosis with Polyangiitis (EGPA) - ANCA Vasculitis Management Algorithm - ACR/VF 2021 Guidelines
• Active

Eosinophilic Granulomatosis ... MithuRheum #EGPA #Eosinophilic ... Guidelines #algorithm #rheumatology

Scleroderma Like Conditions - Differential Diagnosis
Eosinophilic Fasciitis:
- Orange peel induration (peau d'orange) of proximal extremities

Differential Diagnosis Eosinophilic ... facei peripheral eosinophilia ... plasma cells, and eosinophils ... comparison #table #dermatology

Causes of Thrombocytosis - Differential Diagnosis Algorithm
Spurious:
• Artifact (redo CBC)
Autonomous:
• Essential thrombocytosis
• Polycythemia

Non malignant hematologic ... states • Non-hematologic ... Algorithm #Causes #Hematology

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
Definition:
• Severe adverse drug reaction, characterized by

Reaction with Eosinophilia ... lymphadenopathy, eosinophilia ... Eosinophilia 4 ... DRESS #Syndrome #dermatology

NAACP mnemonic for the major causes of Eosinophilia
N = Neoplasia (CML, Hodgkins lymphoma)
A =

major causes of Eosinophilia ... infections #Eosinophilia

ANCA-Associated Vasculitis
A group of necrotizing, small-vessel vasculitis without immune complex deposition. Complement levels are normal due

polyangiitis (MPA), and eosinophilic ... polyangiitis - MPO>PR3 Eosinophilic ... PR3 #Diagnosis #Rheumatology

Eosinophilic Bronchitis - Bronchoscopy revealed diffuse nodules in the tracheobronchial mucosa (Panel A). Biopsy of a

Eosinophilic Bronchitis ... nodule revealed eosinophilic ... #Bronchoscopy #Eosinophilic

Approach to Leukocytosis - Differential Diagnosis Algorithm

Features of hematologic malignancy:
• Symptoms: B-symptoms, bruising/bleeding, fatigue/weakness, immunosuppression

Features of hematologic ... Diagnosis #Algorithm #hematology

Erythroderma - Diagnostic Algorithm. Pathophysiology: 1) Extensive cutaneous capillary dilation, results in widespread exfoliation of the

Exfoliative toxin 2) Eosinophils ... #Diagnosis #Dermatology

Fingernails of patient with Eosinophilic granulomatosis with polyangiitis on chronic glucocorticoids

#Fingernails #nails #Churg #Strauss #vasculitis

of patient with Eosinophilic ... clinical #photo #dermatology

Eosinophils swarming a nematode on Microscopy - Time Lapse

#Eosinophils #nematode #clinical #video #Microscopy #microbiology #TimeLapse

Eosinophils swarming ... - Time Lapse #Eosinophils

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Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome Treatment
Stop offending agents:
• List as allergies

Reaction with Eosinophilia ... Treatment #Management #dermatology

Notice that there are multiple densities in both lungs.
The larger ones are ill-defined and maybe there

There was no eosinophilia ... which excludes eosinophilic

Acute Kidney Injury - AKI Workup Algorithm and Differential Diagnosis
Baseline Investigations: full blood count with differential,

Interstitial nephritis: eosinophilia ... , eosinophiluria

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