The role of peripheral eosinophilia in diagnosing lung disorders:
experience from a single pneumonological center
Abstract
Rationale, aims and objective: Eosinophilia is rare, but one of the
important reasons to refer patients to pneumonological centers.
Determining its etiology has practical implications for therapeutic
intervention and disease prognosis. The study aimed to determine the
role of peripheral eosinophilia in the diagnosis of lung disorders.
Methods: The prospective study included 46 consecutive patients
diagnosed with peripheral eosinophilia with coexisting respiratory
symptoms and/or radiologically detected lung lesions. All patients
underwent standard diagnostic procedures, including a detailed clinical
history review, physical examination, routine laboratory tests with
basal cardiological examinations, and serological tests to detect
parasites and allergies. Other procedures carried out depended on the
symptoms of each patient. Results: Severe eosinophilia (≥5,000 cells/μL)
was associated with extrapulmonary involvement and constitutional
symptoms. Skin, heart, and pleural diseases were more frequent in these
patients than in patients with mild or moderate eosinophilia (p=0.010,
p=0.040, and p=0.007, respectively), and only these patients showed
signs of kidney disease (p=0.006). Vasculitis was significantly more
frequent in the severe eosinophilia group (p=0.048) than in the other
two groups. In patients with moderate eosinophilia (1,500-5,000
cells/μL), extrapulmonary symptoms were less common, although signs of
cardiac involvement were confirmed in 44% of subjects. In this group,
vasculitis was the most commonly observed disease (42% of cases). Mild
eosinophilia (<1,500 cells/μL) was mainly associated with
airway disease. In this group, vasculitis and interstitial lung diseases
were identified, but most were not typically connected with
eosinophilia. Conclusion: Identification of peripheral eosinophilia
essentially determines diagnostic procedures in patients with lung
disorders and can be a useful indicator of disease etiology.