Hypereosinophilic syndrome (HES)
These are a group of rare disorders in which high numbers of eosinophils are found in the blood and tissue for at least 1 month or more. Most people have blood eosinophil levels of less than 500/ml. People with HES can have blood levels of more than 1,500/ml measured on multiple occasions. High eosinophils levels can cause organ or tissue damage. This is due to when they enter the tissues and cause inflammation or damage.
HES can affect any organ in the body. These can be the stomach/intestines, lungs, and skin. Males 20 to 50 years old are more commonly affected. It is diagnosed in adulthood but can be seen in children.
Causes
- For some people, HES can be linked to a mutation in white blood cells. You can get this over your lifetime.
- It is thought to be linked to allergic diseases or hyperactive allergic responses in others.
- For some people, it can be related to cancers.
Symptoms can be:
- Cough
- Fever
- Fatigue
- Shortness of breath and wheezing.
- Rash
- Abdominal pain, nausea, vomiting, diarrhea
- This depends on the part of your body that is affected.
Exams and tests
- Complete blood cell count
- Blood tests for Liver, heart, kidney function
- Vitamin B12, IgE, and tryptase level
- Stool and blood parasite tests
Other studies you may have are:
- Cardiac echocardiography
- Chest x-ray
- Bone marrow biopsy
- Chest, abdomen, pelvis CT scan.
Treatment can be:
- Steroids
- Immunomodulatory medicines such as hydroxyurea, methotrexate,
- Interferon-alpha
- Tyrosine kinase inhibitors, like imantinib
- Anti-interleukin-5 (IL-5) monoclonal antibodies, such as mepolizumab, reslizumab, benralizumab