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Hypereosinophilia and Hypereosinophilic Syndrome

 • Secondary Hypereosinophilic Syndrome
 • Clinically Relevant HES Variants
 • When to
Hypereosinophilia ... and Hypereosinophilic ... Syndrome • ... Syndrome • Clinically ... #Syndrome #HES
Hypereosinophilia Syndrome (HES) - Diagnosis and Management
Definition: An absolute eosinophil count (AEC) greater than 1500 and
Hypereosinophilia ... Syndrome (HES) ... Alert_Oriented3 #Hypereosinophilia ... #Syndrome #HES
Differential Diagnosis of Pulmonary Eosinophilia
Infection:
 • Helminthic: Loffler syndrome (Ascaris, hookworm, Strongyloides), Tropical pulmonary eosinophilia (lymphatic
Helminthic: Loffler syndrome ... eosinophilia, Hypereosinophilic ... syndrome, Neoplasms
Eosinophilia - Differential Diagnosis Algorithm
Idiopathic Eosinophilia
Primary Eosinophilia:
 • Primary hypereosinophilic syndrome
 • Eosinophilic Leukemia
 • MPN/MDS
Eosinophilia: • Primary hypereosinophilic ... syndrome • Eosinophilic ... Hyper-lgE (Job) syndrome ... ABPA), Gleich syndrome ... Infectious: Loeffler syndrome
Causes of Eosinophilia - Differential Diagnosis
Bugs:
 - Fungus (aspergillosis)
 - Viral (HIV)
 - Ectoparasites (scabies, myiasis)
Leukemia - Primary Hypereosinophilic ... Syndrome - Chronic
Secondary Causes of Esophageal Eosinophilia (EoE) - Differential Diagnosis
 • Gastroesophageal reflux disease
 • Eosinophilic gastrointestinal
Achalasia • Hypereosinophilic ... syndrome • Esophageal ... • Hyper-IgE syndrome ... hamartoma tumor syndrome ... • Netherton's syndrome
Categories of disease to consider for eosinophilic meningitis:
-Multicellular parasites (worms and flukes)
-Fungal: Cocci
-Atypical bacterial/mycobacterial: TB, syphilis,
Hypereosinophilic ... syndrome) -Infiltrative
Huge mural thrombus occupying 1/3 the LV.
MI effecting [LAD territory]

In PLAX view, The unechoic line between
[apical HOCM , hypereosinophilic ... syndrome ,fibroma
Cardiomyopathies 

Manifestations of cardiomyopathy (CM) range from microscopic alterations in cardiac myocytes to fulminant Heart Failure
) • Short QT Syndrome ... Hypereosinophilic ... syndrome) • Inflammatory
Approach to Eosinophilic Lung Diseases
 • Acute Eosinophilic Pneumonia (< 1 wk) - ~30yo, M; Recent
, CV, renal • Hypereosinophilic ... Syndrome (> 6 mo