Eosinophilia pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Overview

Eosinophilia is a laboratory finding rather than a diagnosis, and can arise from different pathologic processes. Causes of eosinophilia fall into three general groups: primary eosinophilia (caused by a proliferative neoplasm in the bone marrow), reactive eosinophilia (another disease process creates high levels of cytokines that induce the bone marrow to produce eosinophils), and idiopathic.

Pathophysiology

Primary Eosinophilia: eosinophils are a type of granulocytic white blood cell produced in the bone marrow from myeloid precursors. A neoplasm of these bone marrow cells can lead to massive overproduction of eosinophils. Such neoplasia include acute and chronic eosinophilic leukemia, as well as some myelofibrotic or myelodysplastic syndromes. These are primary causes of eosinophilia since the bone marrow itself it dysregulated.

Reactive Eosinophilia: the eosinophil precursor cells in the bone marrow are responsive to various molecular signals, including IL-3 and IL-5. When these signals are present at high levels, the bone marrow can respond by increasing production of eosinophils to abnormally high levels. Reactive eosinophilia can be caused by a wide variety of causes, including helminthic infections, hematologic and solid organ malignancies, etc. Eosinophilia in these cases is "reactive" because the bone marrow is responding appropriately to elevated levels of cytokines caused by another process.

Idiopathic: no caused for the elevated eosinophil count can be discovered

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