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Zhao XC, Ju B, Wei N, Ding J, Meng FJ, Zhao HG. Severe hyperlipemia-induced pseudoerythrocytosis - Implication for misdiagnosis and blood transfusion: A case report and literature review. World J Clin Cases 2020; 8:4595-4602. [PMID: 33083423 PMCID: PMC7559684 DOI: 10.12998/wjcc.v8.i19.4595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/30/2020] [Accepted: 08/29/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Severe hyperlipemia (SHLE) has an impact on the results of many kinds of laboratory tests. Complete blood count (CBC) examination by automated blood cell counter (ABCC) is a quick and convenient measurement for screening abnormalities of blood cells that are triggered by various pathogenic insults in disease diagnosis and for monitoring changes in the treatment of existing hematological conditions. However, CBC results are frequently affected by many intrinsic and extrinsic factors from blood samples, such as in the setting of hypergammaglobulinemia and certain anticoagulants. SHLE could also affect CBC results.
CASE SUMMARY A 33-year-old Chinese male presented with painful foot numbness and abdominal pain. He was initially misdiagnosed as having a myeloproliferative neoplasm (MPN) because of the marked abnormalities in CBC examination by the ABCC. Morphological evaluation of the bone marrow smears and biopsy showed no evidence of MPN. Gene mutations in Breakpoint cluster regions-Abelson murine leukemia viral oncogene homologue 1 (BCR-ABL1), Janus kinase 2 (JAK2), calreticulin (CALR), myeloproliferative leukemia virus (MPL), and colony-stimulating factor 3 receptor (CSF3R) were negative. Having noticed the thick chylomicron layer on blood samples and the dramatically fluctuating CBC results, we speculated that the fat droplets formed by shaking the blood samples in the setting of SHLE were mistakenly identified as blood cells due to the limited parameters of ABCC. Therefore, we removed a large part of the chylomicron layer and then reexamined the CBC, and the CBC results, as we expected, differed significantly from that of the sample before the chylomicron layer was removed. These significant differences had been validated by the subsequently repeated laboratory tests by measuring dual blood samples that the chylomicron layer was removed in one sample and was not in another, and comparing the CBC results. Computerized tomography reexamination of the upper abdomen revealed an exudative lesion surrounding his pancreas. After intensive consultation, definitive diagnosis was made as recurrent pancreatitis, hyperlipemia and pseudoerythrocytosis.
CONCLUSION SHLE may become a potential cause of misdiagnosis of hyperlipemia-related diseases as MPNs and the resultant mistreatment. It may also lead to the misinterpretation of transfusion indications in patients with hematological disorders who critically need blood transfusion for supportive treatment.
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Affiliation(s)
- Xi-Chen Zhao
- Department of Hematology, The Central Hospital of Qingdao West Coast New Area, Qingdao 266555, Shandong Province, China
| | - Bo Ju
- Department of Hematology, The Central Hospital of Qingdao West Coast New Area, Qingdao 266555, Shandong Province, China
| | - Na Wei
- Department of Hematology, The Central Hospital of Qingdao West Coast New Area, Qingdao 266555, Shandong Province, China
| | - Jian Ding
- Department of Clinical Laboratory, The Central Hospital of Qingdao West Coast New Area, Qingdao 266555, Shandong Province, China
| | - Fan-Jun Meng
- Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Hong-Guo Zhao
- Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
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102
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Ruan GJ, Smith CJ, Day C, Harmsen WS, Zblewski DL, Alkhateeb H, Begna K, Al-Kali A, Litzow MR, Hogan W, Gangat N, Patnaik MS, Pardanani A, Tefferi A, Go RS, Shah MV. A population-based study of chronic eosinophilic leukemia-not otherwise specified in the United States. Am J Hematol 2020; 95:E257-E260. [PMID: 32533865 DOI: 10.1002/ajh.25906] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 06/10/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Gordon J Ruan
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Caleb J Smith
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Courtney Day
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | - William S Harmsen
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Kebede Begna
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| | - Aref Al-Kali
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| | - Mark R Litzow
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| | - William Hogan
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| | - Naseema Gangat
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Ayalew Tefferi
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| | - Ronald S Go
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| | - Mithun V Shah
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
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103
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Nourian A, Hekmatimoghaddam S, Sazmand A. Improper Report of Schistosoma haematobium and Associated Vesical Carcinoma in a Young Man from Iran. IRANIAN JOURNAL OF PARASITOLOGY 2020; 15:463-465. [PMID: 33082814 PMCID: PMC7548465 DOI: 10.18502/ijpa.v15i3.4214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Alireza Nourian
- Department of Pathobiology, Faculty of Veterinary Science, Bu-Ali Sina University, Hamedan, Iran
| | - Seyedhossein Hekmatimoghaddam
- Department of Laboratory Sciences, School of Paramedicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Alireza Sazmand
- Department of Pathobiology, Faculty of Veterinary Science, Bu-Ali Sina University, Hamedan, Iran
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104
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Biologics for the Treatment of Allergic Conditions: Eosinophil Disorders. Immunol Allergy Clin North Am 2020; 40:649-665. [PMID: 33012326 DOI: 10.1016/j.iac.2020.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Eosinophil-associated diseases are characterized by a common pathogenetic background, represented by eosinophil-led inflammation and overexpression of interleukin (IL)-5. IL-5 and its receptor are excellent therapeutic targets for eosinophil-associated diseases. Three monoclonal antibodies targeting IL-5 currently are available: mepolizumab and reslizumab block circulating IL-5 preventing the binding to its receptor, whereas benralizumab binds to IL-5 receptor α. They have a steroid-sparing effect in eosinophil disorders, such as eosinophilic granulomatosis with polyangiitis, hypereosinophilic syndrome, allergic bronchopulmonary aspergillosis, eosinophilic esophagitis, and chronic eosinophilic pneumonia. The biotechnological drugs targeting IL-5 are promising therapies; however, further studies are needed.
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105
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Gerds AT, Gotlib J, Bose P, Deininger MW, Dunbar A, Elshoury A, George TI, Gojo I, Gundabolu K, Hexner E, Hobbs G, Jain T, Jamieson C, Kuykendall AT, McMahon B, Mohan SR, Oehler V, Oh S, Pardanani A, Podoltsev N, Ranheim E, Rein L, Salit R, Snyder DS, Stein BL, Talpaz M, Thota S, Vachhani P, Wadleigh M, Walsh K, Ward DC, Bergman MA, Sundar H. Myeloid/Lymphoid Neoplasms with Eosinophilia and TK Fusion Genes, Version 3.2021, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2020; 18:1248-1269. [PMID: 32886902 DOI: 10.6004/jnccn.2020.0042] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Eosinophilic disorders and related syndromes represent a heterogeneous group of neoplastic and nonneoplastic conditions, characterized by more eosinophils in the peripheral blood, and may involve eosinophil-induced organ damage. In the WHO classification of myeloid and lymphoid neoplasms, eosinophilic disorders characterized by dysregulated tyrosine kinase (TK) fusion genes are recognized as a new category termed, myeloid/lymphoid neoplasms with eosinophilia and rearrangement of PDGFRA, PDGFRB or FGFR1 or with PCM1-JAK2. In addition to these aforementioned TK fusion genes, rearrangements involving FLT3 and ABL1 genes have also been described. These new NCCN Guidelines include recommendations for the diagnosis, staging, and treatment of any one of the myeloid/lymphoid neoplasms with eosinophilia (MLN-Eo) and a TK fusion gene included in the 2017 WHO Classification, as well as MLN-Eo and a FLT3 or ABL1 rearrangement.
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Affiliation(s)
- Aaron T Gerds
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | | | | | | | | | | | | | - Ivana Gojo
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
| | | | | | | | - Tania Jain
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
| | | | | | | | | | - Vivian Oehler
- Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
| | - Stephen Oh
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | | | | | | | | | - Rachel Salit
- Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
| | | | - Brady L Stein
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | | | | | | | - Katherine Walsh
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | - Dawn C Ward
- UCLA Jonsson Comprehensive Cancer Center; and
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106
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Cytogenetics in the genomic era. Best Pract Res Clin Haematol 2020; 33:101196. [DOI: 10.1016/j.beha.2020.101196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/30/2020] [Accepted: 05/27/2020] [Indexed: 02/06/2023]
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107
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Grimes AB, Miller MB, Elghetany MT, Marcogliese AN, Schafer ES. A Case of a Very Young Child With T Lymphoblastic Lymphoma With Eosinophilia and PDGFRB Translocation: A Rare Form of Myeloid/Lymphoid Neoplasm Associated With Eosinophilia and Rearrangements of PDGFRA, PDGFRB or FGFR1. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2020; 20:e990-e993. [PMID: 32921591 DOI: 10.1016/j.clml.2020.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/10/2020] [Accepted: 08/17/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Amanda B Grimes
- Department of Pediatrics, Baylor College of Medicine, Houston, TX; Texas Children's Cancer and Hematology Centers, Houston, TX
| | - Matthew B Miller
- Department of Pediatrics, Oregon Health Sciences University, Portland, OR
| | - M Tarek Elghetany
- Department of Pediatrics, Baylor College of Medicine, Houston, TX; Texas Children's Cancer and Hematology Centers, Houston, TX; Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX
| | - Andrea N Marcogliese
- Department of Pediatrics, Baylor College of Medicine, Houston, TX; Texas Children's Cancer and Hematology Centers, Houston, TX; Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX
| | - Eric S Schafer
- Department of Pediatrics, Baylor College of Medicine, Houston, TX; Texas Children's Cancer and Hematology Centers, Houston, TX.
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108
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Mattis DM, Wang SA, Lu CM. Contemporary Classification and Diagnostic Evaluation of Hypereosinophilia. Am J Clin Pathol 2020; 154:305-318. [PMID: 32525541 DOI: 10.1093/ajcp/aqaa056] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To provide an in-depth review of the classification and diagnostic evaluation of hypereosinophilia (HE), with a focus on eosinophilic neoplasms. METHODS A review of published literature was performed, and exemplary HE cases were identified. RESULTS Causes of HE are diverse and can be grouped under three categories: primary (neoplastic), secondary (reactive), and idiopathic. Advances in cytogenetics and molecular diagnostics have led to elucidation of the genetic basis for many neoplastic hypereosinophilic disorders. One common molecular feature is formation of a fusion gene, resulting in the expression of an aberrantly activated tyrosine kinase (TK). The World Health Organization endorsed a biologically oriented classification scheme and created a new major disease category, namely, "myeloid/lymphoid neoplasms with eosinophilia and rearrangement of PDGFRA, PDGFRB or FGFR1, or with PCM1-JAK2." Rearrangement of other TK genes and activating somatic mutation(s) in TK genes have also been reported in eosinophilic neoplasms. Diagnostic evaluation of HE involves a combination of clinical, histopathologic, and immunophenotypic analyses, as well as molecular genetic testing, including next-generation sequencing-based mutation panels. The management of primary HE is largely guided by the underlying molecular genetic abnormalities. CONCLUSIONS A good knowledge of recent advances in HE is necessary to ensure prompt and accurate diagnosis, as well as to help optimize patient care.
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Affiliation(s)
- Daiva M Mattis
- Departments of Pathology and Laboratory Medicine, University of California, San Francisco, San Francisco
| | - Sa A Wang
- Department of Hematopathology, MD Anderson Cancer Center, Houston, TX
| | - Chuanyi M Lu
- Departments of Pathology and Laboratory Medicine, University of California, San Francisco, San Francisco
- San Francisco VA Healthcare System, San Francisco, CA
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109
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Ricci F, Balducci S, Guerrini F, Grassi S, Ciabatti E, Baratè C, Ferreri MI, Giuliani C, Valetto A, Petrini M, Galimberti S. Sorafenib Induced Complete Cytogenetic and Molecular Response in a Chronic Eosinophilic Leukemia Case with t(12;13) Translocation. Clin Hematol Int 2020; 2:129-131. [PMID: 34595453 PMCID: PMC8432331 DOI: 10.2991/chi.k.200714.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 07/05/2020] [Indexed: 12/01/2022] Open
Affiliation(s)
- Federica Ricci
- Department of Clinical and Experimental Medicine, UO Hematology, University of Pisa, Pisa, Italy
| | - Serena Balducci
- Department of Clinical and Experimental Medicine, UO Hematology, University of Pisa, Pisa, Italy
| | - Francesca Guerrini
- Department of Clinical and Experimental Medicine, UO Hematology, University of Pisa, Pisa, Italy
| | - Susanna Grassi
- Department of Clinical and Experimental Medicine, UO Hematology, University of Pisa, Pisa, Italy
| | - Elena Ciabatti
- Department of Clinical and Experimental Medicine, UO Hematology, University of Pisa, Pisa, Italy
| | - Claudia Baratè
- UO Hematology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | | | - Cecilia Giuliani
- UO Cytogenetics, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Angelo Valetto
- UO Cytogenetics, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Mario Petrini
- Department of Clinical and Experimental Medicine, UO Hematology, University of Pisa, Pisa, Italy
| | - Sara Galimberti
- Department of Clinical and Experimental Medicine, UO Hematology, University of Pisa, Pisa, Italy
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110
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Abstract
The evaluation of gastrointestinal pathology in children often requires a different approach from that in adults. In this concise review, the authors outline 3 diagnostic challenges that are often encountered in daily practice; these include eosinophilic diseases, duodenal intraepithelial lymphocytosis with preserved villous architecture, and terminal ileal inflammation in the setting of idiopathic inflammatory bowel disease.
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Affiliation(s)
- Juan Putra
- Department of Laboratory Medicine and Pathobiology, University of Toronto, 555 University Avenue, Toronto, Ontario M5G1X8, Canada; Division of Pathology, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G1X8, Canada
| | - Jeffrey D Goldsmith
- Department of Pathology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
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111
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Morsia E, Reichard K, Pardanani A, Tefferi A, Gangat N. WHO defined chronic eosinophilic leukemia, not otherwise specified (CEL, NOS): A contemporary series from the Mayo Clinic. Am J Hematol 2020; 95:E172-E174. [PMID: 32243620 DOI: 10.1002/ajh.25811] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 03/25/2020] [Accepted: 03/28/2020] [Indexed: 01/18/2023]
Affiliation(s)
- Erika Morsia
- Division of HematologyMayo Clinic Rochester Minnesota USA
| | - Kaaren Reichard
- Division of HematopathologyMayo Clinic Rochester Minnesota USA
| | | | - Ayalew Tefferi
- Division of HematologyMayo Clinic Rochester Minnesota USA
| | - Naseema Gangat
- Division of HematologyMayo Clinic Rochester Minnesota USA
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112
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Hana CK, Caldera H. Hypereosinophilic Syndrome, Multiorgan Involvement and Response to Imatinib. Cureus 2020; 12:e8493. [PMID: 32656011 PMCID: PMC7343300 DOI: 10.7759/cureus.8493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Hypereosinophilic syndrome (HES) is an uncommon syndrome characterized by peripheral blood eosinophils count of more than 1,500/mm3 with associated tissue damage. It can be either primary or secondary, for example, due to parasitic infections or inflammation. We present a case of a 49-year-old Asian female with recurrent hospital admissions for cholecystitis, gastritis, urinary cystitis, and pancreatitis. Her peripheral blood count showed excessive eosinophils 15,600-19,000/mm3 on different occasions. Pathology of her gallbladder and her gastric biopsies showed eosinophilic infiltration. Her bone marrow biopsy showed a normocellular marrow with active trilineage hematopoiesis, eosinophilia, mild megakaryocytic hyperplasia with a few atypical forms, and mild T-cell lymphocytosis. Flow cytometry showed no evidence of acute leukemia, or T-cell or B-cell lymphoproliferative disorder. On fluorescent in-situ hybridization (FISH), myeloproliferative neoplasms (MPN) testing was negative for platelet-derived growth factor receptor-alpha (PDGFRA), platelet-derived growth factor receptor-beta (PDGFRB), and fibroblast growth factor receptor-1 (FGFR1) rearrangement. Despite not having the FIP1L1‐PDGFRA (factor interacting with PAPOLA and CPSF1-platelet-derived growth factor receptor, alpha polypeptide) gene fusion, our patient responded to the treatment with a significant decrease in her absolute eosinophils count and resolution of her symptoms.
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Affiliation(s)
| | - Humberto Caldera
- Hematology/Oncology, Hematology/Oncology Associates, Palm Beach, USA
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113
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Moller D, Tan J, Gauiran DTV, Medvedev N, Hudoba M, Carruthers MN, Dehghan N, Berghe J, Bruyère H, Chen LY. Causes of hypereosinophilia in 100 consecutive patients. Eur J Haematol 2020; 105:292-301. [DOI: 10.1111/ejh.13437] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Daniel Moller
- Department of Medicine University of British Columbia Vancouver BC Canada
| | - Julia Tan
- Department of Medicine University of British Columbia Vancouver BC Canada
| | | | - Nadia Medvedev
- Division of Hematopathology University of British Columbia Vancouver BC Canada
| | - Monika Hudoba
- Division of Hematopathology University of British Columbia Vancouver BC Canada
| | | | - Natasha Dehghan
- Division of Rheumatology University of British Columbia Vancouver BC Canada
| | - Janette Berghe
- Department of Pathology and Laboratory Medicine University of British Columbia and Cytogenomics LaboratoryVancouver General Hospital Vancouver BC Canada
| | - Helene Bruyère
- Department of Pathology and Laboratory Medicine University of British Columbia and Cytogenomics LaboratoryVancouver General Hospital Vancouver BC Canada
| | - Luke Y.C. Chen
- Division of Hematology University of British Columbia Vancouver BC Canada
- Centre for Health Education Scholarship University of British Columbia Vancouver BC Canada
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114
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Hu Z, Wang W, Thakral B, Chen Z, Estrov Z, Bueso-Ramos CE, Verstovsek S, Medeiros LJ, Wang SA. Lymphocytic variant of hypereosinophilic syndrome: A report of seven cases from a single institution. CYTOMETRY PART B-CLINICAL CYTOMETRY 2020; 100:352-360. [PMID: 32157815 DOI: 10.1002/cyto.b.21874] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 02/09/2020] [Accepted: 02/26/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Lymphocytic variant of hypereosinophilic syndrome (L-HES) is a subtype of HES driven by cytokines produced by clonal T-cells. Due to the rarity of its occurrence and challenges in diagnosis, this subtype of HES is under recognized. METHODS AND RESULTS We report seven patients with L-HES, diagnosed from a group of 136 patients who were referred to our institution for the work-up of hypereosinophilia. The clinical presentation, symptoms and signs were heterogeneous and uncharacteristic; indistinguishable from idiopathic HES. Flow cytometry immunophenotypic analysis revealed aberrant T-cells in all patients, with a Th2 immunophenotype, CD2 + CD3-CD4 + CD5 + CD7dim+/-CD8- in six of seven (86%) cases. CD10 was partially expressed in one of seven (14%) cases, and clonal TCR gene rearrangement was detected by PCR in five of seven (71%) patients. All patients were treated with corticosteroids and two of seven (29%) patients received anti-IL5 antibody therapy. With a median follow-up time of 7.5 years (2.3-14.1 years), one (11%) patient developed peripheral T-cell lymphoma 6.1 years after the initial diagnosis of L-HES and responded well to chemotherapy. All patients were alive at the last follow-up. CONCLUSION In conclusion, a combination of flow cytometry immunophenotyping and molecular analysis allows the identification of aberrant T-cells, facilitating a diagnosis of L-HES in patients with eosinophilia. A correct diagnosis is essential for the proper management of these patients.
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Affiliation(s)
- Zhihong Hu
- Department of Pathology, The University of Texas Health Center at Houston, Houston, Texas, USA
| | - Wei Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Beenu Thakral
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Zhining Chen
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Zeev Estrov
- Department of Pathology, Affiliated Tumor Hospital, Guangxi Medical University, Nanning, China
| | - Carlos E Bueso-Ramos
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Srdan Verstovsek
- Department of Pathology, Affiliated Tumor Hospital, Guangxi Medical University, Nanning, China
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sa A Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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115
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Not just another kinase mutation! Blood 2019; 134:2335-2337. [PMID: 31877214 DOI: 10.1182/blood.2019003650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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