Causes of eosinophilic disorders: A Synthesis of Findings from 13 Studies

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Original Abstract of the Article

Major Research Findings

Hypereosinophilic vasculitis has been reported as a potential manifestation of hypereosinophilic syndrome (HES). This condition is characterized by digital necrotizing, systemic vasculitis that affects varying-sized blood vessels.

The eosinophilias encompass a broad range of nonhematologic (secondary or reactive) and hematologic (primary, clonal) disorders with potential for end-organ damage. 12 , 3 , 9 , , 11 , 8 , 7 , 10

Eosinophilic pneumonias (EP) encompass a wide spectrum of lung diseases characterized by peripheral blood eosinophilia (>1 x 10(9) eosinophils/l) and/or alveolar eosinophilia (>25%).

Reasons for the Causes

The causes of eosinophilic disorders are diverse, and they can be classified into various types, such as primary or secondary, clonal or reactive. 12 , 3 , 9 , , 11 , 8 , 7 , 10

General Causes

Infections

Parasitic infections can be a cause of eosinophilic disorders.

Allergies

Allergies can cause eosinophilic disorders.

Drugs

Drugs can be a cause of eosinophilic disorders. , 5

Genes

ORM (yeast)-like protein isoform 3 (ORMDL3) has recently been identified as a candidate gene for susceptibility to asthma.

Cancer

Chronic eosinophilic leukemia-not otherwise specified (NOS) is rare among hematological malignancies.

Countermeasures for the Causes

Steroids

Steroids are the cornerstone of symptomatic treatment for eosinophilic disorders.

Immunosuppressants

Immunosuppressants are used in the treatment of eosinophilic disorders.

Kinase inhibitors

Kinase inhibitors are used in the treatment of eosinophilic disorders.

Biologicals

Biologics that target IL-5 and eosinophils may provide new options for management.

Dietary management

Dietary strategies, such as amino acid-based formulas, allergy test-directed elimination diets, and nondirected empiric elimination diets, are effective for the treatment of eosinophilic esophagitis (EoE).

Endoscopic dilation

Endoscopic dilation is used for the treatment of fibrostenotic complications of EoE.

Comparison between Studies

Common Points

Many studies have shown that eosinophilic disorders encompass a wide range of diseases and have the potential for end-organ damage. 12 , 3 , 9 , , 11 , 8 , 7 , 10

Differences

There may be differences in the causes, symptoms, and treatments of eosinophilic disorders among studies. For example, hypereosinophilic vasculitis has been reported as a potential manifestation of HES, but other studies have shown that the development of HES may be caused by clonal diseases. , , ,

Cautions Regarding Application to Real Life

Eosinophilic disorders can be caused by a variety of factors and can have a wide range of symptoms. Therefore, it is difficult to determine whether your symptoms are due to an eosinophilic disorder, and what treatment is appropriate. If you suspect you may have an eosinophilic disorder, it is important to see a doctor. The doctor will perform tests, such as blood tests and imaging scans, to confirm the diagnosis. The doctor will also select the appropriate treatment based on the cause and proceed with the treatment. , 6

Limitations of Current Research

Research on eosinophilic disorders is still in its early stages. There are many unknowns, such as the causes, pathogenesis, and treatment. It is expected that more detailed information will be revealed in future research. 3 , 13

Future Research Directions

The following points are challenges in eosinophilic disorder research: * Elucidation of the pathogenesis of eosinophilic disorders * Development of more effective treatments * Development of new diagnostic methods Further research is needed to overcome these challenges. 3 , 13

Conclusion

Eosinophilic disorders can be caused by a variety of factors and can have a wide range of symptoms. Diagnosis is difficult, and there is no established treatment. However, recent research has been progressing and gradually revealing information about the causes, pathogenesis, and treatment. It is hoped that further research will lead to the development of more effective treatments. 3 , 13

Literature analysis of 13 papers
Positive Content
7
Neutral Content
1
Negative Content
5
Article Type
1
0
1
8
13
1.

What causes worsening of eczema? A systematic review.

Author: LanganS M, WilliamsH C

Eczema flare factor identification
Limited evidence
Small sample size

This review systematically assessed the evidence supporting the roles of individual 'flare factors' in eczema. There is very little good evidence for the role of certain foods, house dust mite, stress, and seasonal factors in causing worsening of eczema. No good evidence was found to support the role of detergents, textiles, and irritants in causing worsening of eczema. Studies of longitudinal design are required to clarify the roles of these and other putative flare factors in eczema.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

2.

Supporting self-care for families of children with eczema with a Web-based intervention plus health care professional support: pilot randomized controlled trial.

Author: SanterMiriam, MullerIngrid, YardleyLucy, BurgessHana, SelingerHannah, StuartBeth L, LittlePaul

Eczema improvement
Web-based intervention
HCP support not strongly valued
Website use not always consistent

A pilot trial of a web-based intervention to support families of children with eczema found that the intervention group had a decrease of ≥2 in follow-up compared with baseline POEM score in 55% of participants. The trial found that HCP support was not strongly valued by participants and did not lead to better outcomes or website use than use of the web-based intervention alone.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Hypereosinophilic syndrome: diagnosis and treatment.

Author: Peros-GolubicićTatjana, Smojver-JezekSilvana

Effective for FIP1L1-positive patients

This review highlights that hypereosinophilic syndrome is a heterogeneous group of disorders with some having a clearly defined pathogenesis. Imatinib mesylate is a highly effective treatment for FIP1L1- platelet-derived growth factor receptor alpha and beta rearranged eosinophilic disorders. Further research is needed to identify and treat other treatable subgroups of hypereosinophilic syndrome.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

5.

Possible lansoprazole-induced eosinophilic syndrome.

Author: SmithJ D, ChangK L, GumsJ G

Lansoprazole-induced eosinophilic syndrome

A case report suggests a possible association between lansoprazole administration and eosinophilic syndrome, characterized by myalgia and eosinophilia. While other causes cannot be ruled out, the temporal relationship between lansoprazole use and symptom onset suggests a possible causative link.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

Pediatric Eosinophilia: A Review and Multiyear Investigation into Etiologies.

Author: NessTara E, EricksonTimothy A, DiazVeronica, GrimesAmanda B, RochatRyan, AnvariSara, HajjarJoud, WeatherheadJill

Eosinophilia

This study retrospectively reviewed the records of 771 pediatric patients presenting with peripheral eosinophilia. Allergy was the most common cause, followed by unknown etiology, infectious causes, and eosinophilic disorders. The study found that many patients with an unknown cause had limited or no follow-up testing, highlighting the need for further investigation into the etiology of eosinophilia. A diagnostic algorithm is presented to guide primary care pediatricians in the evaluation of eosinophilia.

ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

World Health Organization-defined eosinophilic disorders: 2019 update on diagnosis, risk stratification, and management.

Author: ShomaliWilliam, GotlibJason

Eosinophil-mediated organ damage

The eosinophilias encompass a broad range of disorders with potential for end-organ damage. Treatment is risk-adapted, with the goal of mitigating eosinophil-mediated organ damage.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

9.

World Health Organization-defined eosinophilic disorders: 2014 update on diagnosis, risk stratification, and management.

Author: GotlibJason

Corticosteroid treatment
Imatinib response
Limited treatment options
Organ damage

The goal of therapy is to mitigate eosinophil-mediated organ damage. For patients with milder forms of eosinophilia without symptoms or signs of organ involvement, a watch and wait approach with close-follow-up may be undertaken.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

10.

World Health Organization-defined eosinophilic disorders: 2015 update on diagnosis, risk stratification, and management.

Author: GotlibJason

End-organ damage

This review discussed the diagnosis, risk stratification, and treatment of eosinophilia. The review highlights the importance of identifying the subtype of eosinophilia in order to choose the most appropriate treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

11.

World Health Organization-defined eosinophilic disorders: 2011 update on diagnosis, risk stratification, and management.

Author: GotlibJason

Improved response to imatinib
Organ damage

This study reviewed the eosinophilias, a group of disorders with potential for end-organ damage, and outlined a semi-molecular classification scheme for primary eosinophilias. The goal of therapy is to mitigate eosinophil-mediated organ damage.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

12.

World Health Organization-defined eosinophilic disorders: 2017 update on diagnosis, risk stratification, and management.

Author: GotlibJason

Reduced organ damage

The goal of therapy for hypereosinophilia is to mitigate eosinophil-mediated organ damage. Risk-adapted therapy is recommended, with treatment ranging from observation to aggressive therapy based on disease subtype and severity.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

13.

International Consensus Recommendations for Eosinophilic Gastrointestinal Disease Nomenclature.

Author: DellonEvan S, GonsalvesNirmala, AboniaJ Pablo, AlexanderJeffrey A, ArvaNicoleta C, AtkinsDan, AttwoodStephen E, AuthMarcus K H, BaileyDominique D, BiedermanLuc, BlanchardCarine, BonisPeter A, BoseParoma, BredenoordAlbert J, ChangJoy W, ChehadeMirna, CollinsMargaret H, Di LorenzoCarlo, DiasJorge Amil, DohilRanjan, DupontChristophe, FalkGary W, FerreiraCristina T, FoxAdam T, GentaRobert M, GreuterThomas, GuptaSandeep K, HiranoIkuo, HiremathGirish S, Horsley-SilvaJennifer L, IshiharaShunji, IshimuraNorihisa, JensenElizabeth T, Gutiérrez-JunqueraCarolina, KatzkaDavid A, KhouryPaneez, KinoshitaYoshikazu, KliewerKara L, KoletzkoSibylle, LeungJohn, LiacourasChris A, LucendoAlfredo J, MartinLisa J, McGowanEmily C, Menard-KatcherCalies, MetzDavid C, MillerTalya L, MoawadFouad J, MuirAmanda B, MukkadaVincent A, MurchSimon, NhuQuan M, NomuraIchiro, NurkoSamuel, OhtsukaYoshikazu, OlivaSalvatore, OrelRok, PapadopoulouAlexandra, PatelDhyanesh A, PesekRobert D, PetersonKathryn A, PhilpottHamish, PutnamPhilip E, RichterJoel E, RosenRachel, RuffnerMelanie A, SafroneevaEkaterina, SchreinerPhilipp, SchoepferAlain, SchroederShauna R, ShahNeil, SouzaRhonda F, SpechlerStuart J, SpergelJonathan M, StraumannAlex, TalleyNicholas J, ThaparNikhil, VandenplasYvan, VenkateshRajitha D, VieiraMario C, von ArnimUlrike, WalkerMarjorie M, WechslerJoshua B, WershilBarry K, WrightBenjamin L, YamadaYoshiyuki, YangGuang-Yu, ZevitNoam, RothenbergMarc E, FurutaGlenn T, AcevesSeema S

Standardized terminology

This international consensus process utilized Delphi methodology to develop standardized nomenclature for eosinophilic gastrointestinal diseases (EGIDs). "EGID" was agreed upon as the preferred umbrella term, replacing "eosinophilic gastroenteritis." Specific naming conventions by location of GI tract involvement are recommended, such as eosinophilic gastritis (EoG), eosinophilic enteritis (EoN), and eosinophilic colitis (EoC). This standardized nomenclature will improve clinical and research communication and understanding of EGIDs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

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