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World Allergy Organization
WAO's mission: To be a global resource and advocate in the field of allergy, advancing excellence in clinical care through education, research and training as a world-wide alliance of allergy and clinical immunology societies.

Differential Diagnosis of Eosinophilic Conditions

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Hans-Uwe Simon, MD, PhD
Institute of Pharmacology
University of Bern
Bern, Switzerland

Eosinophils and their products play an essential role in the pathogenesis of various reactive and neoplastic disorders. Depending on the underlying disease, molecular defect and involved cytokines, eosinophilia may develop that subsequently could lead to organ damage. In other patients, persistent eosinophilia is accompanied by typical clinical findings, but the causative role and impact on eosinophilia remain uncertain. For patients with eosinophil-mediated organ pathology, early therapeutic intervention with agents reducing eosinophil counts can be effective in limiting or preventing irreversible organ damage. Therefore, it is important to approach eosinophil disorders and related syndromes early by using established criteria, to perform all appropriate staging investigations, and to search for molecular targets of therapy. Here, I will review current concepts in the pathogenesis of eosinophilia and eosinophil-related organ damage in neoplastic and nonneoplastic conditions. I will also discuss possible diagnostic algorithms.

Key References:

D. Simon, H.-U. Simon: Eosinophilic disorders. J. Allergy Clin. Immunol. 119 (2007), 1291-1300.

H.-U. Simon, M.E. Rothenberg, B.S. Bochner, P.F. Weller, A.J. Wardlaw, M.E. Wechsler, L.J. Rosenwasser, F.
Roufosse, G.J. Gleich, A.D. Klion: Refining the definition of hypereosinophilic syndrome. J. Allergy Clin. Immunol.
126 (2010), 45-49.

A. Klion, H.-U. Simon: Therapeutic approaches to patients with hypereosinophilic syndrome. Semin. Hematol.
49 (2012), 160-170.

P. Valent, G.J. Gleich, A. Reiter, F. Roufosse, P.F. Weller, A. Hellmann, G. Metzgeroth, K.M. Leiferman, M. Arock,
K. Sotlar, J.H. Butterfield, S. Cerny-Reiterer, M. Mayerhofer, P. Vandenberghe, T. Haferlach, B.S. Bochner, J.
Gotlib, H.P. Horny, H.-U. Simon, A.D. Klion: Pathogenesis and classification of eosinophil disorders: a review
of recent developments in the field. Expert Rev. Haematol. 5 (2012), 157-176.