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Hypereosinophilia
Introduction
- A rare disease in which the major findings are elevated circulating eosinophils with mature eosinophilic infiltration of many organs.
- Cause: unknown.
- Signs: usually include anorexia, weight loss, vomiting and diarrhea.
- Diagnosis: based on ruling out other causes of eosinophilia.
- Treatment: prednisolone and/or hydroxyurea, or prednisolone and ciclosporin.
- Prognosis: poor.
Presenting signs
- Diarrhea (with or without blood).
- Weight loss.
- Anorexia.
- Vomiting.
- Pruritus.
- Dyspnea or abdominal distention.
- Weakness.
Acute presentation
- Seizures.
Age predisposition
- Any age, usually mature cats. Females may be over-represented.
- Skin lesions reported in younger cats only.
Cost considerations
- A diagnosis of exclusion - diagnostic procedures moderately expensive.
- Treatment is inexpensive.
Special risks
- May have increased risk of pneumothorax Pneumothorax following anesthesia or bronchoalveolar lavage Bronchoalveolar lavage. In man there is an increased risk of thrombosis.
Pathogenesis
Etiology
- The cause is unknown. Theories include:
- Intrinsic bone marrow disorder.
- Uncontrolled reactive process, eg hypersensitivity.
- Stimulation of or altered regulation of eosinophil production.
Pathophysiology
- Circulating eosinophila with widely disseminated eosinophilic infiltration of many organs and hyperplasia of the bone marrow eosinophil lineages.
- There is peripheral eosinophilia, bone marrow hyperplasia of eosinophil lines and infiltration of multiple organs by mature eosinophils, which leads to organ failure.
- Organs commonly involved are:
- Bone marrow (needs careful differentiation from eosinophilic leukemia).
- Small intestine (eosinophilic enteritis Gastroenteritis can be part of hypereosinophilic syndrome).
- Spleen.
- Mesenteric and peripheral lymph nodes.
- Liver.
- Skin lesions.
- Where pleural effusion Pleural effusion, ascites or pulmonary edema are seen, this may be attributed to cardiac failure. Cardiomyopathy has been reported in two cases and histological infiltration of the heart has been noted in several. (Cardiac disease is common in man.)
- The pathophysiology of the rarer clinical signs (reported in 1 or 2 cats only) remains obscure.
Timecourse
- Weeks to months.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Haynes S M, Hodge P J, Lording P et al (2011) Use of prednisolone and cyclosporine to manage idiopathic hypereosinophilic syndrome in a cat. Aust Vet Pract 41 (2), 76-81 ResearchGate.
- Takeuchi Y, Matsuura S, Fujino Y et al (2008) Hypereosinophilic syndrome in two cats. J Vet Med Sci 70 (10), 1085-1089 PubMed.
- Sharfi H, Nassiri S M, Esmaelli H et al (2007) Eosinophilic leukaemia in a cat. JFMS 9 (6), 514-517 PubMed.
- Huibregtse B A & Turner L J (1994) Hypereosinophilic syndrome and eosinophilic leukaemia: A comparison of 22 hypereosinophilic cats. JAAHA 30 (6), 591-599 VetMedResource.
- Plotnick A (1994) Hypereosinophilic syndrome in a cat. Feline Practice 22 (5), 28-31 VetMedResource.
- Muir P, Gruffydd-Jones T J & Brown P J (1993) Hypereosinophilic syndrome in a cat. Vet Rec 132 (14), 358-359 PubMed.
- Neer T M (1991) Hypereosinophilic syndrome in cats. Comp Cont Ed Pract Vet 13 (4), 549-555 AGRIS FAO.
- Saxon B, Hendrick M & Waddle J R (1991) Restrictive cardiomyopathy in a cat with hypereosinophilic syndrome. Can Vet J 32 (6), 367-369 PubMed.
- Harvey R G (1990) Feline hypereosinophilia with cutaneous lesions. JSAP 31 (9), 453-456 VetMedResource.
- Center S A, Randolph J F, Erb H N et al (1986) Eosinophilia in the cat - a retrospective study of 312 cases (1975 to 1986). JAAHA 26 (4), 349-358 VetMedResource.
- Scott D W, Randolph J F & Walsh K M (1985) Hypereosinophilic syndrome in a cat. Feline Practice 15 (1), 22-30 VetMedResource.
- Hendrick M (1981) A spectrum of hypereosinophilic syndromes exemplified by six cats with eosinophilic enteritis. Vet Pathol 18 (2), 188-200 PubMed.