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356 Part two Host Defense Mechanisms and Inflammation

TABLE 24.2 Eosinophil-associated Diseases and Disorders
allergic or atopic Diseases
Asthma
Allergic rhinitis
Eosinophilic esophagitis
Atopic dermatitis
Allergic urticaria
Nasal polyps
Myeloproliferative and Neoplastic Disorders
Hypereosinophilic syndromes: myeloproliferative, lymphoproliferative, and others
Leukemia
Lymphoma- and tumor-associated
Mastocytosis

Pulmonary Syndromes
Parasite-induced eosinophilic lung diseases:
Loeffler syndrome: patchy migratory infiltrates, resolving over weeks, seen with transpulmonary migration of helminth parasites, especially Ascaris
Tropical pulmonary eosinophilia: miliary lesions and fibrosis; heightened immune response causing one form of lymphatic filariasis; increased
immunoglobulin E (IgE) and antifilarial antibodies
Pulmonary parenchymal invasion: paragonimiasis
Heavy hematogenous seeding with helminths: trichinellosis, schistosomiasis, larva migrans
Allergic bronchopulmonary aspergillosis
Chronic eosinophilic pneumonia: dense peripheral infiltrates, fever; progressive, blood eosinophilia may be absent; steroid responsive
Acute eosinophilic pneumonia: acute presentation diagnosed by bronchoalveolar lavage or biopsy
Eosinophilic granulomatosis with polyangiitis (Churg–Strauss syndrome) vasculitis: small- and medium-sized arteries; granulomas, necrosis; asthma often
antecedent; extrapulmonary (e.g., neurological, cutaneous, cardiac, or gastrointestinal) involvement likely
Drug- and toxin-induced eosinophilic lung diseases
Other: hypereosinophilic syndromes, neoplasia, bronchocentric granulomatosis

Skin and Subcutaneous Diseases
Skin diseases: atopic dermatitis, blistering diseases, including bullous pemphigoid, urticarias, drug reactions
Diseases of pregnancy: pruritic urticarial papules and plaques syndrome, herpes gestationis
Eosinophilic pustular folliculitis
Eosinophilic cellulitis (Wells syndrome)
Kimura disease and angiolymphoid hyperplasia with eosinophilia
Shulman syndrome (eosinophilic fasciitis)
Episodic angioedema with eosinophilia: recurrent periodic episodes with fever, angioedema, and secondary weight gain; may be long-standing without
untoward cardiac dysfunction
Gastrointestinal Disorders
Eosinophilic gastroenteritides
Inflammatory bowel disease: eosinophils in lesions; occasionally blood eosinophilia with ulcerative colitis
rheumatologic Diseases
Vasculitis: Eosinophilic granulomatosis with polyangiitis (Churg–Strauss) and cutaneous necrotizing eosinophilic vasculitis
Immunological reactions
Medication-related eosinophilias
Immunodeficiency diseases: Job’s syndrome and Omenn syndrome
Transplant rejections
Endocrine
Hypoadrenalism: Addison disease, adrenal hemorrhage, hypopituitarism
other Causes of Eosinophilia
Atheromatous cholesterol embolization
Hereditary
Serosal surface irritation, including peritoneal dialysis and pleural eosinophilia
Adapted from Weller PF. Eosinophilia and eosinophil-related disorders. In: Adkinson NF, Jr., Yunginger JW, Busse WW, et al., eds. Allergy: Principles and Practice, 6th ed.
Philadelphia, Penn.: Mosby; 2003:1105.