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960 Part VII: Neutrophils, Eosinophils, Basophils, and Mast Cells Chapter 62: Eosinophils and Related Disorders 961

presentation depending on the main organ affected and the description Eosinophiluria and Eosinophilorrachia
of the disease in case series is influenced by the medical discipline of The urinary excretion of eosinophils is seen in several inflammatory
the reporting team. In the past, EGPA carried a poor prognosis with disorders of the kidney but most often in urinary tract infection or acute
a 10 percent 1-year survival, but currently 5-year survival is greater interstitial nephritis. Hansel stain is superior to Wright stain in iden-
206
than 90 percent. In most cases, patients go into remission with high- tifying eosinophils in a stained urinary sediment. Cerebrospinal fluid
dose oral glucocorticoids, although guidelines recommend the use of eosinophilia may occur with infection, shunts, and allergic reactions
other immunosuppressants, such as cyclophosphamide or azathioprine, involving the meninges. 207
to induce remission where there is evidence of life-threatening organ
involvement. 199,200 Once remission is achieved the patient often requires
lifelong oral glucocorticoids to maintain remission. Relapse is not REFERENCES
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9
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is present in most patients, but may be intermittent. A biopsy, usually 24. Kiwamoto T, Brummet ME, Wu F, et al: Mice deficient in the St3gal3 gene product
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ingestion of a particular batch of l-tryptophan. Glucocorticoids are therapeutic target for eosinophilic disorders. J Allergy Clin Immunol 133:1439–1447.
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