Evaluation of Etiological Factors Causing Hypereosinophilia in Children

Öz

Objective: Patients with persistent eosinophilia may have many conditions ranging from relatively benign diseases such as parasitic serious infections to life-threatening serious diseases. We aimed to determine the etiological causes of hypereosinophilia in children. 

Material and Methods: Patients under 18 years of age who had complete blood counts in Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital’s pediatric clinics between January 2013-January 2016 were retrospectively analyzed. Hypereosinophilia was defined as having at least two peripheral blood absolute eosinophil counts greater than or equal to 1500/mm3.The results of the examinations and diagnoses when the patients were detected with hypereosinophilia were recorded from the hospital records.

Results: Three hundred and forty patients who underwent complete blood count were found to have hypereosinophilia. Seventy patients whose file records could not be accessed were excluded from the study. Two-hundred seventy patients (56% male) with a median age of 5 (IQR:1-12) years were included in our study. When the diagnoses of patients were examined, 48 (17.8%) had allergic diseases, 21 (7.8%) had immunodeficiency, 14 (5.2%) had parasitic disease. 15 (5.5%) had tumor, 4 (1.5%) had leukemia, 2 (0.7%) had hypereosinophilic syndrome, 2 (0.7%) had adrenal insufficiency and 2 (0.7%) had burn. Ninety-nine (36.7%) patients were found to use medication for any disease (acute or chronic). As a result of the examinations performed in 63 (23.3%) patients, it was found that there was no reason to explain hypereosinophilia.

Conclusion: The number of eosinophils may increase in many conditions. The cause of increase in eosinophil may not always be found. Further studies are needed on the long-term prognosis of these patients.

Anahtar Kelimeler

• hypereosinophilia
• childhood
• parasitic infections
• allergic diseases
• immunologic diseases

Çocuklarda Hipereozinofiliye Neden Olan Etiyolojik Faktörlerin Değerlendirilmesi

Öz

Amaç: Hipereozinofili hastaları, paraziter enfeksiyonlar gibi nispeten iyi huylu hastalıklardan yaşamı tehdit eden ciddi hastalıklara kadar pek çok duruma sahip olabilir. Çalışmamızda çocuklarda hipereozinofilinin etiyolojik nedenlerinin belirlenmesi amaçlanmıştır.

Gereç ve Yöntemler: Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji Eğitim ve Araştırma Hastanesi pediatri kliniklerinde Ocak 2013 - Ocak 2016 tarihleri arasında tam kan sayımı yapılan 18 yaş altı hastalar retrospektif olarak incelendi. En az iki tam kan sayımı ölçümünde periferik kan mutlak eozinofil sayısının 1500/mm3 veya daha büyük olması hipereozinofili olaral kabul edildi. Hastane kayıtlarından hipereozinofili tespit edildiğinde yapılan tetkik ve tanıların sonuçları kaydedildi.

Bulgular: Tam kan sayımı yapılan çocuk hastaların 340’ında hipereozinofili olduğu tespit edildi. Dosya kayıtlarına ulaşılamayan 70 hasta çalışma dışı bırakıldı. Çalışmamıza, yaşları ortanca 5 (1-12) [ortanca (çeyrekler arası aralık (ÇAA)] yıl olan 270 (%56’sı erkek) hasta dahil edildi. Hastalara konulan tanılar incelendiğinde: 48’ine (%17.8) alerjik hastalık, 21’ine (%7.8) immün yetmezlik, 14’üne (%5.2) paraziter hastalık, 15’ine tümör (%5.6), 4’üne (%1.5) lösemi, 2’sine (%0.7) hipereozinofilik sendrom, 2’sine (%0.7) adrenal yetmezlik, 2’sine (%0.7) yanık tanısı konulduğu tespit edildi. Doksan dokuz (%36.7) hastada ise herhangi bir hastalık için (akut veya kronik) ilaç kullanımı (antibiyotik, antiepileptik, demir şelatörü gibi) olduğu tespit edildi. Altmış üç (%23.3) hastada ise yapılan tetkikler sonucunda hipereozinofiliyi açıklayacak bir neden bulunamadığı görüldü.

Sonuç: Kanda eozinofil sayısı pek çok durumda da yükselebilir. Eozinofil yüksekliğinin sebebi her zaman bulunamayabilir. Bu hastaların uzun dönem prognozları hakkında yapılacak ileri çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• çocukluk çağı
• hipereozinofili
• alerjik hastalıklar
• immünolojik hastalıklar
• paraziter enfeksiyonlar

Kaynakça

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