{"id":3910,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/eosinophilia\/"},"modified":"2023-07-27T15:33:22","modified_gmt":"2023-07-27T14:33:22","slug":"eosinophilia","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/haematology\/eosinophilia\/","title":{"rendered":"Eosinophilia"},"content":{"rendered":"\nEosinophilia<\/title>\n\n\n\n<h4 class=\"wp-block-heading\">Definition<\/h4>\n\n\n\n<p>Eosinophilia is defined as an elevation of the eosinophil count above 0.4 x10<sup>9<\/sup>\/L. The initial step in the evaluation of eosinophilia is to rule out reactive (secondary) causes- please see the Primary Care Management page.<\/p>\n\n\n\n<p>The most common causes of eosinophilia are allergy, eczema\/asthma, drug-induced and parasitic infections.<\/p>\n\n\n\n<p>After reactive causes have been ruled out, the patient may be referred to Haematology for investigation of clonal eosinophilia.<\/p>\n\n\n\n<p><strong>C.M & L.W 26-06-23<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<p>Patients with significant persistent eosinophilia (\u2265 1.5 x 10<sup>9<\/sup>\/L) without obvious underlying reactive cause.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Reactive eosinophilia \u2013 the patient may require assessment by other specialties, e.g. Rheumatology, Dermatology, Infectious Disease, Respiratory Medicine depending on symptoms<\/li>\n\n\n\n<li>Patients with persistent unexplained mild to moderate eosinophilia (0.4-1.4 x10<sup>9<\/sup>\/L) can be given a diagnosis of idiopathic eosinophilia once secondary causes have been excluded.<\/li>\n<\/ul>\n\n\n\n<p><em>Please see Primary Care Management for initial investigative approaches.<\/em><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<p>SCI Gateway to the Department of Haematology WGH or SJH.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h3 class=\"wp-block-heading\">Primary care investigations<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Look for underlying causes such as\n<ul class=\"wp-block-list\">\n<li>Allergic disorders such as atopic eczema, asthma, hay fever<\/li>\n\n\n\n<li>Drugs<\/li>\n\n\n\n<li>Parasites<\/li>\n\n\n\n<li>Vasculitis (e.g. eosinophilic granulomatosis with polyangiitis)<\/li>\n\n\n\n<li>Allergic bronchopulmonary aspergillosis<\/li>\n\n\n\n<li>Malignancy<\/li>\n\n\n\n<li>Hodgkin lymphoma.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p><strong><u>Investigations:<\/u><\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>FBC + film<\/li>\n\n\n\n<li>CRP<\/li>\n\n\n\n<li>U&E, LFT, LDH<\/li>\n\n\n\n<li>Stools x 3 for ova, cysts and parasites<\/li>\n\n\n\n<li>Repeat FBC at 3 months.<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/bjh.14488\">Guideline for the investigation and management of eosinophilia – Butt – 2017 – British Journal of Haematology – Wiley Online Library<\/a><\/p>\n\n\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Eosinophilia Definition Eosinophilia is defined as an elevation of the eosinophil count above 0.4 x109\/L. The initial step in the evaluation of eosinophilia is to rule out reactive (secondary) causes- please see the Primary Care Management page. The most common causes of eosinophilia are allergy, eczema\/asthma, drug-induced and parasitic infections. After reactive causes have been<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3981,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[258],"class_list":["post-3910","page","type-page","status-publish","hentry","category-eosinophilia"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/haematology\/eosinophilia\/\" rel=\"tag\">Eosinophilia<\/a>","rttpg_excerpt":"Eosinophilia Definition Eosinophilia is defined as an elevation of the eosinophil count above 0.4 x109\/L. The initial step in the evaluation of eosinophilia is to rule out reactive (secondary) causes- please see the Primary Care Management page. The most common causes of eosinophilia are allergy, eczema\/asthma, drug-induced and parasitic infections. After reactive causes have been","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3910","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=3910"}],"version-history":[{"count":5,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3910\/revisions"}],"predecessor-version":[{"id":15780,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3910\/revisions\/15780"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3981"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=3910"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=3910"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}