Value of laboratory findings in the diagnosis of hypereosinophilia
Magnaval, J.F.
Medecine Tropicale Revue du Corps de Sante Colonial 58(4 Suppl): 493-498
1998
ISSN/ISBN: 0025-682X PMID: 10410373 Document Number: 490160
The investigation of hypereosinophilias (HE) is a long and complicated process requiring a close collaboration between biologist and clinician physicians. The latter especially will have to provide information on symptoms (association with a fever; a hepatitis) and on the epidemiological history (patient's occupation and country of origin, and/or time and place of the travels or stays out of the European Union). The first step of laboratory investigations consists of making a check blood count, then measuring the sedimentation rate. At the time of the second step, the measurement of total IgE (a concentration greater than 500 IU/ml is often linked to a helminthiasis), that of specific IgE for common inhalant allergens, and three stool examinations using Baermann's technique will be carried out. The request for parasitic serodiagnoses only will be done if the above-cited investigations are negative, and if HE persists after a therapeutic test. A panel of serological tests often needs to be performed. If a helminthic infection is suspected but the immunodiagnostic methods fail, these tests may be required again after a time of a few weeks. At this stage, the measurement of eosinophil cationic protein is useful, since a high level of eosinophil cationic protein is suggestive of non allergic HE.