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Idiopathic Hypereosinophilic Syndrome/Eosinophilic Leukaemia (Case Report): A Challenge to Diagnose

Received: 26 February 2015     Accepted: 27 February 2015     Published: 3 August 2015
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Abstract

Hypereosinophilic syndrome (HES) was first described by Hardy and Anderson in 1968 . HES may result either from eosinophilic differentiation of a clone of neoplastic cells or from reactive eosinophilia. It appears lightly that in many patients idiopathic HES is actually a chronic myeloproliferative disorder. There is vaguely overlapping clinico-pathological picture of HES with (Chronic eosinophilic leukaemia) CEL which often adds to diagnostic confusion. In 2001, the World Health Organization (WHO) proposed a set of criteria that distinguish CEL from HES. An evidence of genetic clonality of eosinophils or an increase in blast cells in blood or bone marrow is mandatory for diagnosis of CEL, while no specific diagnostic tests exists for HES, making it an entity of exclusion. A 36 year old female presented with intermittent fever and dry cough since two months. Clinical examination revealed mild pallor with hepatosplenomegaly. Chest examination showed bilateral basal crepitations. The patient was subjected for hematological, biochemical and radiological assessment. The peripheral smear and bone marrow aspirates revealed presence of eosinophilic precursors with predominance of eosinophiloblasts associated with eosinophilic myelocytes, metamyelocytes, a few myeloblasts and lymphocytes, the features of which are in favour of CEL. CEL, a rare myeloproliferative entity and its presentation with pulmonary manifestations is still rare in India. Hence, we present this rare entity along with review of available literature.

Published in Science Journal of Clinical Medicine (Volume 4, Issue 4-1)

This article belongs to the Special Issue Latest Different Concepts of Gynaecology

DOI 10.11648/j.sjcm.s.2015040401.14
Page(s) 16-18
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Chronic Eosinophilic Leukaemia, Hypereosinophilic Syndrome, Pulmonary Manifestations

References
[1] Vardiman JW et al Chronic myeloproliferative diseasesand Myelodysplastic / myeloproliferative diseases. World Health Organization Classificationof Tumours. Pathology and Genetics.Tumours of Haematopoietic and Lymphoid Tumours. H. N. Jaffe ES, Stein H, Vardiman JW. Lyon, France, IARC Press: 2001, 17–31, 47–52.
[2] Yamada Y, Rothenberg M.E, Cancelas J.A. Current concepts on the pathogenesis of the hypereosinophilic syndrome/chronic eosinophilic leukaemia. Translational Oncogenomics 2006:1
[3] Bain B.J. British journal Hematol 1996 ;95,2-9
[4] Babu K.V.S, Chowhan A.K, Rukmangadha N, Vengamma B, Reddy M.K. Chronic eosinophilic leukaemia : a case report. J Clin Sci Res 2012; 1 : 46-8
[5] Brito-Babapulle F. Blood Rev, 1997 ; 11,129-45
[6] Fletcher S and Bain B. Eosinophilic Leukaemia. British Medical Bulletin 2007; 81 & 82:115-127
[7] Kumar A, Sinha S, Tripathi A.K. Chronic Eosinophilic Leukaemia: a case report and review of literature. Indian J Hematol, Blood Transfusion.2014, 23:112-115
[8] Chusid, M.J., Dale, D.C., West, B.C. and Wolff, S.M.. The hypereosinophilic syndrome: analysis of fourteen cases with review of the literature. Medicine (Baltimore) 1975 54:1–27.
[9] Bain, B., Pierre, R., Imbert, M., Vardiman, J.W., Brunning, R.D. andFlandrin, G.2001 Chronic eosinophilic leukaemia and the hypereosinophilic syndrome. IARC Press, Lyon, France.
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    Sathyavathi Alva, Angshuman Saha, Tahera Syed, T. M. Kariappa. (2015). Idiopathic Hypereosinophilic Syndrome/Eosinophilic Leukaemia (Case Report): A Challenge to Diagnose. Science Journal of Clinical Medicine, 4(4-1), 16-18. https://doi.org/10.11648/j.sjcm.s.2015040401.14

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    ACS Style

    Sathyavathi Alva; Angshuman Saha; Tahera Syed; T. M. Kariappa. Idiopathic Hypereosinophilic Syndrome/Eosinophilic Leukaemia (Case Report): A Challenge to Diagnose. Sci. J. Clin. Med. 2015, 4(4-1), 16-18. doi: 10.11648/j.sjcm.s.2015040401.14

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    AMA Style

    Sathyavathi Alva, Angshuman Saha, Tahera Syed, T. M. Kariappa. Idiopathic Hypereosinophilic Syndrome/Eosinophilic Leukaemia (Case Report): A Challenge to Diagnose. Sci J Clin Med. 2015;4(4-1):16-18. doi: 10.11648/j.sjcm.s.2015040401.14

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  • @article{10.11648/j.sjcm.s.2015040401.14,
      author = {Sathyavathi Alva and Angshuman Saha and Tahera Syed and T. M. Kariappa},
      title = {Idiopathic Hypereosinophilic Syndrome/Eosinophilic Leukaemia (Case Report): A Challenge to Diagnose},
      journal = {Science Journal of Clinical Medicine},
      volume = {4},
      number = {4-1},
      pages = {16-18},
      doi = {10.11648/j.sjcm.s.2015040401.14},
      url = {https://doi.org/10.11648/j.sjcm.s.2015040401.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.s.2015040401.14},
      abstract = {Hypereosinophilic syndrome (HES) was first described by Hardy and Anderson in 1968 . HES may result either from eosinophilic differentiation of a clone of neoplastic cells or from reactive eosinophilia. It appears lightly that in many patients idiopathic HES is actually a chronic myeloproliferative disorder. There is vaguely overlapping clinico-pathological picture of HES with (Chronic eosinophilic leukaemia) CEL which often adds to diagnostic confusion. In 2001, the World Health Organization (WHO) proposed a set of criteria that distinguish CEL from HES. An evidence of genetic clonality of eosinophils or an increase in blast cells in blood or bone marrow is mandatory for diagnosis of CEL, while no specific diagnostic tests exists for HES, making it an entity of exclusion. A 36 year old female presented with intermittent fever and dry cough since two months. Clinical examination revealed mild pallor with hepatosplenomegaly. Chest examination showed bilateral basal crepitations. The patient was subjected for hematological, biochemical and radiological assessment. The peripheral smear and bone marrow aspirates revealed presence of eosinophilic precursors with predominance of eosinophiloblasts associated with eosinophilic myelocytes, metamyelocytes, a few myeloblasts and lymphocytes, the features of which are in favour of CEL. CEL, a rare myeloproliferative entity and its presentation with pulmonary manifestations is still rare in India. Hence, we present this rare entity along with review of available literature.},
     year = {2015}
    }
    

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  • TY  - JOUR
    T1  - Idiopathic Hypereosinophilic Syndrome/Eosinophilic Leukaemia (Case Report): A Challenge to Diagnose
    AU  - Sathyavathi Alva
    AU  - Angshuman Saha
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    AB  - Hypereosinophilic syndrome (HES) was first described by Hardy and Anderson in 1968 . HES may result either from eosinophilic differentiation of a clone of neoplastic cells or from reactive eosinophilia. It appears lightly that in many patients idiopathic HES is actually a chronic myeloproliferative disorder. There is vaguely overlapping clinico-pathological picture of HES with (Chronic eosinophilic leukaemia) CEL which often adds to diagnostic confusion. In 2001, the World Health Organization (WHO) proposed a set of criteria that distinguish CEL from HES. An evidence of genetic clonality of eosinophils or an increase in blast cells in blood or bone marrow is mandatory for diagnosis of CEL, while no specific diagnostic tests exists for HES, making it an entity of exclusion. A 36 year old female presented with intermittent fever and dry cough since two months. Clinical examination revealed mild pallor with hepatosplenomegaly. Chest examination showed bilateral basal crepitations. The patient was subjected for hematological, biochemical and radiological assessment. The peripheral smear and bone marrow aspirates revealed presence of eosinophilic precursors with predominance of eosinophiloblasts associated with eosinophilic myelocytes, metamyelocytes, a few myeloblasts and lymphocytes, the features of which are in favour of CEL. CEL, a rare myeloproliferative entity and its presentation with pulmonary manifestations is still rare in India. Hence, we present this rare entity along with review of available literature.
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Author Information
  • Department of Pathology, K. V. G. Medical College, Sullia, D. K, Karnataka, India

  • Department of Pathology, K. V. G. Medical College, Sullia, D. K, Karnataka, India

  • Department of Pathology, K. V. G. Medical College, Sullia, D. K, Karnataka, India

  • Department of Pathology, K. V. G. Medical College, Sullia, D. K, Karnataka, India

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