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Unexplained Hypereosinophilia and the Need for Cytogenetic and Molecular Genetic Analyses
Kathleen J. Smith, MD;
Elizabeth Jacobson, MD;
Sate Hamza, MD;
Henry Skelton, MD
Arch Dermatol. 2004;140:584-588.
Background Idiopathic hypereosinophilic syndrome (HES) is a diagnosis made after the exclusion of other causes of eosinophilia. However, differentiation of idiopathic HES from eosinophilic leukemia is sometimes difficult. In some cases, these diagnoses can be differentiated by cytogenetic or molecular findings, as illustrated in the patients described herein.
Observations We describe 3 patients with HES and associated pruritus; 1 patient also had recurrent lesions of eosinophilic cellulitis. All 3 patients were initially diagnosed as having idiopathic HES, but after evaluation and demonstration of molecular abnormalities, they were classified as having eosinophilic leukemia.
Conclusions Patients with a diagnosis of idiopathic HES should be evaluated for cytogenetic or molecular genetic abnormalities. These abnormalities can establish a diagnosis of chronic eosinophilic leukemia and may provide clues for emerging therapies.
From the Department of Dermatopathology, Quest Diagnostics, Tucker, Ga (Drs Smith and Skelton); Dermatology, St Vincent Hospital, Birmingham, Ala (Dr Jacobson); and the Department of Pathology, University of Alabama at Birmingham (Dr Hamza). The authors have no relevant financial interest in this article. Dr Hamza is now with the Department of Pathology, University of Manitoba, Winnipeg.
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