Work

Eosinophilia and Hypereosinophilia: A Practical Approach to Navigating a Broad Differential Diagnosis

Year: 2026

Type: article

Abstract: /L and may become life-threatening when eosinophil-induced organ damage occurs, defining the hypereosinophilic syndrome (HES). Among the many causes of HE, rare hematological malignancies, in particular the "myeloid/lymphoid neoplasms (MLN) with eosinophilia and tyrosine kinase (TK) gene fusions," represent phenotypically and prognostically heterogeneous and challenging entities. For this reason, the evaluation of HE constitutes a diagnostic and therapeutic challenge. In this review, we provide a concise overview of eosinophil biology, highlight their physiological role as regulators of immunity, tissue homeostasis, and inflammation, their involvement in diseases affecting nearly all organ systems, and in hematological malignancies in particular. Furthermore, we present a practical, stepwise diagnostic approach to HE, emphasizing early recognition of eosinophil-mediated organ dysfunction to initiate timely treatment, as well as red flags that should raise further hematologic evaluation, including molecular and cytogenetic investigations to identify an underlying clonal disorder. Treatment strategies depend on the underlying etiology and range from supportive care, over corticosteroids to targeted biological therapies and tyrosine kinase inhibitors (TKIs).

Source: European Journal Of Haematology

DOI: 10.1111/ejh.70299

Authors: Stijn Wigerinck, Peter Vandenberghe

Institutions: KU Leuven, Universitair Ziekenhuis Leuven

Language: English

Topic: Eosinophilic Disorders and Syndromes

Subfield: Rheumatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,650