What is the cause of the rare eosinophilic diseases EGPA and HES, and how long does it take to diagnose them?
The nature of these diseases is unknown. In a study at the Mayo Clinic in Rochester of 1,500 people who had elevated eosinophil counts above 1,500, only 1 percent of them, or 1 in 100, had acute or chronic eosinophilic leukemia, or eosinoproliferative disease. In contrast, the rest had either HES or EGPA. This shows that the incidence of these diseases is much higher than leukemia, which we immediately suspect as we have a lot of white blood cells. And that's not true. It's not immediately leukemia. Where does it come from? Suspicions vary. Genetic anomalies, viral or other infections, environmental factors that modify cell proliferation, or allergies, or hypersensitivity reactions more broadly said. The fact is that in Poland, morphology is very rarely evaluated for eosinophils. Often, even when I see a blood count test, they just don't mark the composition of white blood cells. And white blood cells are, after all, lymphocytes, neutrophils, eosinophils, basophils. Sometimes monocytes are still added to that. So what we are really missing is good diagnostics. Second, these patients, both with EGPA and hyperoeosinophilic syndrome, present with very different symptoms. Of course, they are most often noted from the respiratory side, but they can also be neurological symptoms, skin symptoms, cardiovascular symptoms. There is no single, specific symptom. Taking into account these two elements, when eosinophils in peripheral...
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