Differential Diagnosis of Eosinophilia

 

Eosinophilia is defined by an elevation in the absolute eosinophil count. A high percent may reflect neutropenia.

 

Hematopoietic neoplasms with a clonal proliferation of eosinophils:

(1) chronic myelogenous leukemia

(2) chronic eosinophilic leukemia

(3) acute myelomonocytic leukemia with eosinophilia

(4) other chronic myeloproliferative disorders

(5) other acute myeloid proliferations

 

Hematopoietic neoplasms with reactive eosinophilia:

(1) ALL with eosinophilia

(2) systemic mast cell disease

(3) Hodgkin's lymphoma

(4) Langerhan cell histiocytosis

(5) T-cell leukemia or lymphoma

(6) angioimmunoblastic lymphadenopathy

 

Other hematologic disorder:

(1) idiopathic hypereosinophilic syndrome

(2) pernicious anemia

(3) familial eosinophilia

 

Allergic or atopic conditions:

(1) asthma

(2) allergic rhinitis

(3) urticaria

(4) atopic dermatitis

(5) hypersensitivity pneumonitis

(6) allergic gastroenteritis

(7) eosinophilic esophagitis

(8) eosinophilic enteritis

 

Immune disorders:

(1) Churg-Strauss syndrome

(2) bullous pemphigoid

(3) pemphigus

(4) eczema

(5) celiac disease

(6) renal allograft rejection

(7) vasculitis

(8) sarcoidosis

(9) ulcerative colitis or Crohn's disease

(10) dermatitis herpetiformis

(11) dermatomyositis

(12) scleroderma

(13) rheumatoid arthritis (RA)

(14) systemic lupus erythematosus (SLE)

(15) periarteritis nodosa (PAN)

(16) Sjogren's syndrome

(17) graft-vs-host disease

(18) autoimmune endocrinopathies

(19) serum sickness

(20) Kimura disease (angiolymphoid hyperplasia with eosinophilia)

(21) episodic angioedema with eosinophilia (Gleich syndrome)

 

Immunodeficiency states:

(1) Wiskott-Aldrich syndrome

(2) selective IgA deficiency with atopy

(3) combined immunodeficiency

(4) hyper-IgE syndrome (HIES, Job's syndrome)

(5) Nezelof's syndrome

 

Drug, toxin or chemical-induced:

(1) recombinant interleukin or other cytokine therapy

(2) eosinophil-myalgia syndrome (3-phenylaminoalanine contamination of L-tryptophan)

(3) toxic oil syndrome

(4) phosphorus

(5) spider bite

(6) granulocyte colony stimulating factor (CSF)

(7) aspirin or NSAID intolerance

(8) hypersensitivity/allergic reaction to a drug

 

Parasitic diseases:

(1) trichinosis

(2) schistosomiasis

(3) filariasis

(4) echinococcosis

(5) visceral larva migrans

(6) tropical eosinophilia

(7) onchoerciasis

(8) fascioliasis

(9) paragonomiasis

(10) strongyloidiasis

(11) ascariasis

(12) hookworm disease

(13) clonorchiasis

(14) scabies

 

Fungal diseases:

(1) coccidioidomycosis

(2) cryptococcosis

(3) allergic bronchopulmonary aspergillosis

 

Other infections:

(1) HIV infection

(2) Chlamydia infection

(3) scarlet fever

(4) cat-scratch fever

(5) chronic active hepatitis

(6) Herpes simplex virus (HSV)

(7) rickettsial infection

(8) HTLV-II infection

 

Pulmonary disease:

(1) bronchiectasis

(2) Loeffler syndrome

(3) cystic fibrosis

(4) prolonged pulmonary infiltrates with eosinophilia

(5) eosinophilic granuloma of the lung

 

Other:

(1) dialysis

(2) carcinoma (female genital tract, breast, lung, renal, other)

(3) post-splenecotmy

(4) eosinophilic gastroenteritis

(5) post-irradiation

(6) eosinophilic cellulitis

(7) acute pancreatitis

(8) tropical endocardial fibrosis

(9) eosinophilic endomyocardial fibrosis