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Eosinophilic lung

Danaraj TJ

Med J Malaya, 1947;4:278-288.

Eight caaes of this condition are described, the patients being four Ceylonese, three Indians, and one Chinese, all males except one. Symptoms consisted of breathlessness and cough, sputum being sometimes purulent and occasionally blood-stained. Six of the patients complained of loss of weight, and in one, a Ceylonese schoolboy, this was the only presenting symptom. The authors found the most troublesome complaint to be a paroxysmal cough which was always worst at night. On clinical examination rhonchi were heard scattered throughout both lung fields in five cases, the lungs being clear in the other three. X-ray examination showed characteristic mottling of both lungs in four cases and of one lung in one case; another showed increased vascular markings, while in two the lungs were clear. Sputum was examined for tubercle bacilli and mites but none were found. The technique used for searching for mites is not described. A marked eosinophilia was found in all cases, the highest count recorded being 33, 264 eosinophils per cmm.Treatment consisted of arsenic, given in the form of neoarsphenamine, six injections of 0.3 gm. in six cases, and stovarsol 4 grains t.d.s. for seven and ten days respectively in the other two. Four of the patients were cured, three were improved, while one was showing a favourable response although treatment had not been completed.The author emphasizes the importance of performing repeated blood counts in order to avoid missing this condition. Out of the eight cases which he describes, one had been wrongly diagnosed as pulmonary tuberculosis and three as bronchial asthma. One of the latter had an initial eosinophil count of 4, 092 which rose to 17, 700 three weeks later. H. T. H. Wilson

Matched MeSH terms: Eosinophilia
Intradermal tests with Dirofilaria immitis extract in eosinophilic lung (tropical eosinophilia)

Danaraj TJ, Schacher JF

Am J Trop Med Hyg, 1959;8:640-643.

The intradermal test using as antigen a 1 per cent saline extract of Dirofilaria immitis powder was performed in Singapore on 69 persons with eosinophilic lung, 32 with mild eosinophilia, 49 with filariasis, 75 normal Asians, and 66 normal Britishers. The test was positive in 100 per cent of the cases of eosinophilic lung, 73.5 per cent of the filariasis group, 59.4 per cent of cases of mild eosinophilia, 53.3 per cent of normal Asians, and 4.5 per cent of the Britishers. The filarial complement fixation test using a 1 per cent alcoholic extract of the same antigen gave a positive rate of 100 per cent in the eosinophilic lung group, whereas only 24.5 per cent of the filariasis patients gave a positive reaction. Skin sensitivity to D. immitis antigen persisted in the cases of eosinophilic lung even when the previously positive serologic reactions had become negative following treatment with diethylcarbamazine. Therefore, the intradermal test cannot be useful in the diagnosis of either filariasis or eosinophilic lung in Singapore. In view of the skin sensitivity to a filarial antigen demonstrated in patients suffering from eosinophilic lung, the etiologic possibility of an infection by a species of filarial worm found normally in nonhuman hosts is discussed.

Matched MeSH terms: Eosinophilia
The etiology and pathology of eosinophilic lung (tropical eosinophilia)

Danaraj TJ, Pacheco G, Shanmugaratnam K, Beaver PC

Am J Trop Med Hyg, 1966 Mar;15.(2):183-9.
PMID: 5910525

The finding of microfilariae in lung tissue from patients with eosinophilic lung is reported and the histopathological appearances are described.

Matched MeSH terms: Eosinophilia/drug therapy; Eosinophilia/etiology; Eosinophilia/pathology
Fulltext Correlation between Soil Transmitted Helminth Infection and Eosinophil Levels among Primary School Children in Medan

Darlan DM, Tala ZZ, Amanta C, Warli SM, Arrasyid NK

Open Access Maced J Med Sci, 2017 Apr 15;5(2):142-146.
PMID: 28507618 DOI: 10.3889/oamjms.2017.014

BACKGROUND: Soil Transmitted Helminth infection is one of most prevalent health problems worldwide, especially in environments with poor sanitation. Based on World Health Organisation (WHO) data, more than 2 billion people, or 24% of the world's population, are infected with intestinal parasite. The highest prevalence is located in areas of poor sanitation and unsafe water supplies. In Indonesia, the prevalence of parasite infections is 15% of the entire population.
AIM: The purpose of this study was to determine the relationship between Soil Transmitted Helminth infection on levels of eosinophils among primary school children. In addition, this study also aimed to determine the prevalence of different types of worm infections and the levels of eosinophils in children infected with worms.
MATERIAL AND METHODS: This study was analytic observational using a cross-sectional method. The sampling technique was consecutive and in total 132 samples was obtained. The study involved primary school children in Amplas Medan and Hamparan Perak, Deli Serdang through May to October 2016. Univariate analysis was performed to determine STH infection prevalence and bivariate analysis was used to find the correlation between STH infection and eosinophil levels through a Chi square (χ2) test.
RESULTS: The results showed that the prevalence of Soil Transmitted Helminth was 7.6%. The most common types of STH infection were 3.8% with Trichuris trichiura and 3% with Ascaris lumbricoides. A significant correlation was found between Parasite infection and eosinophil levels (Contingency Coefficient (C) = 0.2, χ2 = 5.3, p = 0.021) and the risk of STH infection that caused eosinophilia or increased eosinophil levels in the children with a Prevalence Ratio (PR) of 1.56 (Confidence Interval (CI) 95%: 1.10-2.22).
CONCLUSION: It is recommended that schools at similar risk improve and maintain hygiene and healthy behaviour in the school environment and that parents and teachers pay greater attention to the cleanliness of their children.

Matched MeSH terms: Eosinophilia
Filariasis due to Brugia malayi in west Malayasia. I. Clinical, laboratory, and parasitological aspects

Dondero TJ, Ramachandran CP, Bin Yusoff O

Southeast Asian J. Trop. Med. Public Health, 1971 Dec;2(4):503-15.
PMID: 5144151
Matched MeSH terms: Eosinophilia/etiology
Filariasis due to Brugia malayi in West Malaysia. II. Skin test aspects

Dondero TJ, Ramachandran CP

Southeast Asian J. Trop. Med. Public Health, 1972 Mar;3(1):25-30.
PMID: 5028861
Matched MeSH terms: Eosinophilia/complications
Fulltext Evaluation of dot immunogold filtration assay (DIGFA) for rapid serodiagnosis of eosinophilic meningitis due to Angio-strongylus cantonensis (Nematoda: Metastrongyloidea)

Eamsobhana P, Prasartvit A, Gan XX, Yong HS

Trop Biomed, 2015 Mar;32(1):121-5.
PMID: 25801261

Angiostrongylus cantonensis is the most frequent cause of eosinophilic meningitis in humans in Thailand and worldwide. Because of difficulty of recovering the Angiostrongylus larvae from infected patients, detection of parasite-specific antibodies is used to support clinical diagnosis. This study tested serum samples from eosinophilic meningitis patients and individuals at risk of infection with A. cantonensis to evaluate a recently developed simple and rapid dot-immunogold filtration assay (DIGFA) for detection of specific antibodies against A. cantonensis. Purified 31-kDa glycoprotein of A. cantonensis and protein A colloidal gold conjugate were employed to detect the 31-kDa anti-A. cantonensis antibody in patients sera from the parasite endemic areas of northeast Thailand. The results were compared with those obtained by dot-blot enzyme-linked immunosorbent assay (ELISA) with 31-kDa A. cantonensis antigen. The overall positivity rate of DIGFA and dot-blot ELISA for A. cantonensis infection in 98 clinically diagnosed cases from three highly endemic districts in Khon Kaen province were 39.79% and 37.75%, respectively. Among 86 sera of subjects at risk of infection with A. cantonensis, 24.41% were positive by DIGFA and 23.25% by dot-blot ELISA. There were good correlation between the visual grading of DIGFA and dot-blot ELISA in both groups of defined sera. DIGFA is as sensitive and specific as dot-blot ELISA for confirming eosinophilic meningitis due to A. cantonensis infection, with advantages of simplicity, rapidity and without the use of specific and expensive equipment, and can be used in field settings.

Matched MeSH terms: Eosinophilia/diagnosis*
Eosinophilic gastroenteritis

Eravelly J, Ho Hon Fah, Wong Wai Ping

Med J Malaya, 1967 Dec;22(2):130-5.
PMID: 4231978
Matched MeSH terms: Eosinophilia/complications*
Fulltext Unresolved pneumonia: a case report of Strongyloides stercoralis hyperinfection in an immunocompromised patient

Esteban Chin, Lim Han Hua

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):58-58.
MyJurnal

Introduction: Strongyloidiasis is endemic in the tropical and subtropical regions. Clinical manifestations of the dis-ease can range from asymptomatic eosinophilia in an immunocompetent host to a wide range of presentations in immunocompromised patients. Failure to consider the diagnosis of strongyloides infection, especially Strongyloides hyperinfection syndrome, is a major contributor of high mortality rate in such cases. Case Description: We report a case of 60 years old gentleman who was admitted to Sarawak General Hospital for a left subtrochanteric femur pathological fracture and the diagnosis of multiple myeloma was made in the same setting. He was started on treat-ment for multiple myeloma which includes high dose steroids. During his course of admission, he was diagnosed with hospital-acquired pneumonia was subsequently initiated with broad-spectrum antibiotics. Despite being exten-sively treated with multiple courses of broad-spectrum antibiotics, he deteriorated clinically, with eventual respirato-ry failure requiring ventilator support and ICU admission. A diagnosis of strongyloides hyperinfection syndrome was made after an incidental discovery of larvae in his sputum, which was later confirmed with stool sample. He was given a one-week course of albendazole 400mg twice daily and clinical improvement was observed. A repeated stool sample also demonstrated clearance of the parasites. Conclusion: This case highlights the need for clinical sus-picion of strongyloides hyperinfection syndrome in cases of unresolved pneumonia, especially for patients with risk factors of underlying immune-deficiency state. Preventive steps such early detection and eradication of strongyloides infection should be undertaken prior to initiation of immuno-suppressive therapy.

Matched MeSH terms: Eosinophilia
Fulltext Trisomy X and myelodysplastic syndrome (MDS) with eosinophilia

Eusni, R.M.T., Leong, C.F., Salwa, S.

Malaysian Journal of Medicine and Health Sciences, 2012;8(2):65-67.
MyJurnal

We reported a young patient with myelodysplastic syndrome (MDS) with eosinophilia, in which her chromosomal analysis revealed the presence of trisomy X and a marker chromosome at chromosome 11. The technique used to detect the chromosomal abnormalities is a multicoloured –fluorescent in situ hybridization technique (M-FISH). Our observation suggested that these underlying chromosomal abnormalities were probably responsible for her development of MDS with eosinophilia.
Myelodysplastic syndrome (MDS) is a condition whereby there is ineffective production of haematopoietic stem cells and poor quality of cells produced. The cause can either be a primary bone marrow problem, de novo or therapy related. Most MDS cases are secondary rather than primary. Many chromosomal abnormalities have been found in cases of myelodysplastic syndrome. We described a case of MDS with eosinophilia in association with presence of trisomy X and a marker chromosome in chromosome 11.

Matched MeSH terms: Eosinophilia
Fulltext Kimura’s Disease Mimicking Hodgkin’s Lymphoma: An Unusual Cause of Parotid Swelling

Fadilah, S.A.W., Shanty, V., Goh, AS

Medicine & Health, 2007;2(1):99-102.
MyJurnal

Kimura’s disease (KD) is a rare, benign chronic inflammatory disease of unknown aetiology, typically presents in the Orientals as subcutaneous masses in the head and neck region that could be easily misdiagnosed as a malignant tumour, leading to unnecessary radical surgery or intensive cytotoxic therapy. It has been mainly reported in the Chinese and Japanese literature. It is difficult to diagnose before tissue biopsy and fine needle aspiration cytology (FNAC) has limited value. Hence, unless the pathologists are aware of this entity, it might be mistaken as a malignant lesion. We encountered a case of KD in a Malay patient presenting as a parotid mass that was initially diagnosed as Hodgkin’s lymphoma (HL). This disorder should be suspected in young male Asian patients presenting with a painless unilateral mass in the head and neck region with associated hypereosinophilia.

Matched MeSH terms: Angiolymphoid Hyperplasia with Eosinophilia
A rare case of inguinal kimura disease

Gregory X, Soon NI, Nur Aklina R

Med J Malaysia, 2018 10;73(5):326-327.
PMID: 30350814 MyJurnal

Kimura's disease is a rare chronic inflammatory disease of unknown etiology, commonly presenting with painless lymphadenopathy and subcutaneous masses in the head and neck regions.1 However, presentations with inguinal lymphadenopathy are rare and mimics other differentials, may pose a diagnostic challenge. We present a case of a 50-year-old male, with right inguinal swelling for one month duration that was finally diagnosed with Kimura's Disease after a multitude of investigations to rule out differentials of lymphadenopathy, delaying conclusive treatment. Specialized test had been done resonated with the histopathological findings only. We report this case to increase awareness of Kimura's Disease.

Matched MeSH terms: Angiolymphoid Hyperplasia with Eosinophilia
Fulltext Diffuse unilateral subacute neuroretinitis in a young boy: a case report

Guan-Fook N, Hayati AA, Raja-Azmi MN, Liza-Sharmini AT, Wan-Hazabbah WH, Zunaina E

Clin Ophthalmol, 2012;6:487-90.
PMID: 22536041 DOI: 10.2147/OPTH.S29806

We report a case of diffuse unilateral subacute neuroretinitis in a young boy with no clinical visualization of nematode. The diagnosis was made based on clinical findings and detection of Toxocara immunoglobulin G by Western blot test. An 11-year-old Malay boy presented with progressive blurring of vision in the left eye for a duration of 1 year. It was associated with intermittent floaters. Visual acuity in the left eye was 6/45 and improved to 6/24 with pinhole. There was positive relative afferent pupillary defect, impaired color vision, and presence of red desaturation in the left eye. There were occasional cells in the anterior chamber with no conjunctiva injection. Posterior segment examination revealed mild-to-moderate vitritis and generalized pigmentary changes of the retina with attenuated vessels. The optic disk was slightly hyperemic with mild edema. There was presence of multiple, focal, gray-white subretinal lesions at the inferior part of the retina. Full blood picture results showed eosinophilia with detection of Toxocara immunoglobulin G by Western blot test. Investigations for other infective causes and connective tissue diseases were negative. The diagnosis of diffuse unilateral subacute neuroretinitis secondary to Toxocara was made based on clinical findings and laboratory results. He was treated with oral albendazole 400 mg daily for 5 days and oral prednisolone 1 mg/kg with tapering doses over 6 weeks. At 1 month follow-up, the inflammation had reduced, and multiple, focal, gray-white subretinal lesions were resolved; however there was no improvement of vision.

Matched MeSH terms: Eosinophilia
Schultz-Dale reaction with sera of eosinophilic lung patients--a preliminary report

Guest MF, Wong MM

Med J Malaya, 1965 Dec;20(2):146-8.
PMID: 4159506
Matched MeSH terms: Pulmonary Eosinophilia/immunology*
Fulltext Kimura's Disease with Atypical Musculoskeletal Presentation

Hafiz A., Yusuf, A., Rosmaliza, I., Premchandran, N., Kalavathy, R.

Malays Orthop J, 2010;4(2):44-47.
MyJurnal

We would like to highlight an unusual clinical presentation of Kimura's disease, a rare, benign, idiopathic condition, usually seen as swelling and lesions of the head and neck region and commonly affecting young men of Asian descent. It is rare for this disorder to present with lesions on other parts of the body, especially the lower limbs. We report a 27-year-old man who presented with a large mass located at the inguinal region and extending down to the upper thigh. Due to the large size of the mass (28 x 18 cm), our provisional diagnosis was a soft tissue sarcoma. Open biopsy showed that the lesion was benign.

Matched MeSH terms: Angiolymphoid Hyperplasia with Eosinophilia
Fulltext Distribution of anti-Toxoplasma gondii antibodies among Orang Asli (aborigines) in Peninsular Malaysia

Hakim SL, Radzan T, Nazma M

Southeast Asian J. Trop. Med. Public Health, 1994 Sep;25(3):485-9.
PMID: 7777912

The distribution of anti-toxoplasma antibodies among the aborigines in Malaysia and its association with other soil transmitted infections and eosinophilia were studied. A total of 415 serum samples were collected and tested by IFA test. Overall prevalence was 10.6%, lower than previously reported. The antibody titers showed a unimodal distribution peaking at 1:8 dilution. There was a higher proportion of high antibody titer (> 1:128) in the adult compared to the children with no significant difference in prevalence rate by sex. The pattern of infection does not differ from other soil transmitted infections and there was no association between raised Toxoplasma antibodies with eosinophilia.

Matched MeSH terms: Eosinophilia/complications; Eosinophilia/epidemiology
Kinetics of IgA and eosinophils following a low-dose, predominantly Haemonchus contortus infection of Boer goats

Hayyan BN, Sharma RSK, Raimy N, Nisha M, Hussain K, Busin VM, et al.

Parasite Immunol., 2020 06;42(6):e12707.
PMID: 32118305 DOI: 10.1111/pim.12707

AIMS: Most breeds of goat are more susceptible to nematode infection than sheep, and this appears to be a consequence of less effective immune responses. Several papers have considered the effectiveness of eosinophils and immunoglobulin A (IgA) in goats but differences in the induction of responses have not been studied in the same detail. The aim of this study was to look at the induction of eosinophil and IgA responses in Boer goats reared indoors under intensive conditions.
METHODS AND RESULTS: The goats were experimentally infected with a low dose of 2400 Haemonchus contortus, Trichostrongylus spp. and Oesophagostomum spp. at a 6:1:1 ratio. Faecal egg counts (FEC), packed cell volume (PCV), IgA activity against third-stage larvae and peripheral eosinophilia were measured twice a week for eight weeks. The infection generated an IgA response but did not significantly increase peripheral eosinophilia in the 25 infected kids compared with the 4 control animals. FEC was not associated with IgA activity or eosinophilia.
CONCLUSION: A detailed analysis of IgA and eosinophil responses to deliberate nematode infection in Boer goats showed that there was an increase in nematode-specific IgA activity but no detectable eosinophil response. In addition, there was no association between increased IgA activity or eosinophilia with egg counts and worm burdens. These suggest that IgA and eosinophils do not act to control nematode infection in goats.

Matched MeSH terms: Eosinophilia/immunology*; Eosinophilia/parasitology
Fulltext A case of Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss, EGPA) presenting with relapsed Mononeuritis multiplex

Hilmi, B.A., Ainon, M.M.

International Medical Journal Malaysia, 2014;13(1):69-72.
MyJurnal

We report a case of eosinophilic granulomatosis with polyangiitis (EGPA), a rare multisystem disorder characterized by difficult-to-control asthma, hypereosinophilia and polyneuropathy. We also discuss the Five Factor Score (FFS) risk stratification strategy, which is used to quantitate the extent of the disease and guide treatment strategy.

Matched MeSH terms: Eosinophilia
Eosinophilic gastroenteritis complicating acute calculus eosinophilic cholecystitis 6 months after cholecystectomy

Hui CK

J Dig Dis, 2018 Nov;19(11):693-695.
PMID: 30370999 DOI: 10.1111/1751-2980.12683
Matched MeSH terms: Eosinophilia/complications; Eosinophilia/etiology*
Fulltext A Prospective Study on the Prevalence, Extent of Disease and Outcome of Eosinophilic Gastroenteritis in Patients Presenting with Lower Abdominal Symptoms

Hui CK, Hui NK

Gut Liver, 2018 May 15;12(3):288-296.
PMID: 29212311 DOI: 10.5009/gnl17056

Background/Aims: The epidemiology of eosinophilic gastroenteritis remains unclear. We aim to determine the prevalence of eosinophilic gastroenteritis in patients with lower abdominal symptoms.
Methods: In a prospective study, colonoscopy was performed on 2,469 consecutive patients. Biopsies were taken from the terminal ileum and ascending, transverse, descending and sigmoid colon in all patients.
Results: Sixty-four of the 2,469 patients (2.6%) had eosinophilic gastroenteritis. Only five of the 64 patients (7.8%) with eosinophilic gastroenteritis had endoscopic mucosal abnormalities during colonoscopy. Six of these 64 patients (9.4%) had severe disease at presentation, and seven of these 64 patients (10.9%) required systemic steroid treatment. An elevated absolute peripheral eosinophil count was independently associated with severe disease at presentation (4/6 [66.7%] vs 3/58 [5.2%], p=0.005; odds ratio [OR], 25.320; 95% confidence interval [CI], 2.628 to 243.910), and severe disease at the time of presentation was independently associated with the use of systemic steroid treatment (6/7 [85.7%] vs 0/57 [0%], p=0.008; OR, 18.021; 95% CI, 2.163 to 150.152).
Conclusions: The prevalence of eosinophilic gastroenteritis is common, and patients usually present normal-appearing mucosa on colonoscopy. Those with severe disease at presentation usually have a raised absolute peripheral eosinophil count and should be commenced on systemic steroids as an initial therapy.

Matched MeSH terms: Eosinophilia/complications; Eosinophilia/epidemiology; Eosinophilia/therapy*

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