Çocuklarda Eozinofiliye Güncel Yaklaşım

ÖzPeriferik kan eozinofili nedenleri benign eozinofiliden hipereozinofilik sendrom(HES) ve malignitelere kadar değişmektedir. Dikkatli bir öykü ve fizik muayene ile birlikte yapılan klinik değerlendirme, altta yatan nedeni belirlemeye yardımcı olabilir. HES bir dışlama tanısıdır. İlaç alerjisi ve paraziter hastalıklar hipereozinofilinin bilinen sık nedenleri olmasına rağmen, alerjik hastalıklar ve çeşitli immün yetmezliklerde de hipereozinofili görülebilmektedir. Tedavi altta yatan hastalığa göreyapılmaktadır. Orta-ağır eozinofilisi olan hastalarda HES mutlaka düşünülmelidir çünkü gecikmiş tanı ve tedavi organ hasarı ile sonuçlanabilir.

Anahtar Kelimeler:

Hipereozinofilik Sendrom, Eozinofil, EozinofilikHastalıklar, Eozinofili

Çocuklarda Eozinofiliye Güncel Yaklaşım

AbstractThe causes of peripheral blood eosinophilia range from benign eosinophilia to hypereosinophilic syndrome (HES) and malignancies. Clinical evaluation with a careful history and physical examination may help to determine the underlying cause. HES is a diagnosis of exclusion. Although drug allergy and parasitic diseases are common known causes of hypereosinophilia, it can also be seen in allergic diseases andvarious immunodeficiencies. Treatment is based on underlying disease. HES should be considered in patients with moderate to severe eosinophilia because delayed diagnosis and treatment may result in organ damage.

Keywords:

Hypereosinophilic Syndrome, Eosinophilia, Eosinophil, Eosinophilic Disorders,

PDF

___

Kaynaklar 1.Arga M. Eozinofil Biyolojisi. Şekerel B (eds) Çocukluk Çağın-da Alerji Astım İmmünoloji. Ankara: Ada Basın Yayın; 2015;247-259 2.Kita H, Bochner BS. Biology of eosinophils. In: Adkinson FN,Bochner BS, Burks AW, Busse WW, Holgate ST, Lemanske RF,et al (eds). Middleton’s Allergy: Principles and Practice, 8thed. Philadelphia, PA: Elsevier Saunders, 2014;265-279 3.Curtis C, Ogbogu P. Evaluation and differantial diagnosis ofpersistent marked eosinophilia. Immunol Allergy Clin N Am2015;04:1-16 4.Khoury P, Makiya M, Klion AD. Clinical and biological mar-kers in hypereosinophilic syndromes. Frontiers in Medicine2017;4 :1-7 5.Razi CH. Hipereozinofiliye Yaklaşım. Şekerel B (eds) Çocuk-luk Çağında Alerji Astım İmmünoloji. Ankara: Ada Basın Ya-yın; 2015; 335-346 6.Boxer LA, Newburger PE. Eosinophils.In: Kliegman RM, Stan-ton BF, St Geme JW and Schor NF (eds). Nelson Textbook ofPediatrics, 19 th ed.Philadelphia, PA: Elsevier Saunders2011;739-741 7.Klion A, Keller P. Eosinophilia and eosinophil related disor-ders. In: Adkinson FN, Bochner BS, Burks AW, Busse WW,Holgate ST, Lemanske RF, et al (eds). Middleton’s Allergy:Principles and Practice, 8th ed. Philadelphia, PA: ElsevierSaunders, 2014; 1205-1223 8.De A, Rajagophalan M, Sarda A, Das S, Biswas P. Drug re-action with eosinophilia and systemic symptoms: an updateand review of recent literature. Indian J Dermatol2018;63(1):30-40 9.Roufosse F, Weller F. Practical approach to the patient with hype-reosinophilia. J Allergy Clin Immunol 2010; 126 (1) :39-44 10.Valent P, Klion AD, Rosenwasser LJ, Arock M, Bochner BS,Butterfield JH et al. ICON: Eosinophilic disorders. WAO Jo-urnal 2012;5:174-181 11.Turgut B. Hipereozinofilik sendromlar. Hematolog 2012;2:81-92 12.Simon H, Rothenburg ME, Bochner BS, Weller P, Wardlaw AJ,Wechsler ME et al. Refining the definition of heypereosinop-hilic syndrome. J Allergy Clin Immunol 2010; 126: 45-49 13.Wechsler ME, Fulkerson PC, Bochner BS, Gauvreau GM, Gle-ich GJ, Henkel T et al. Novel targeted therapies for eosinop-hilic disorders. J Allergy Clin Immunol 2012;130 (3):563-571 14.Gotlib J. World Health Organization-defined eosinophilic di-sorders:2017 update in diagnosis, risk stratification, and ma-nagement. Am J Hematol 2017;92:1243-1259 15.Boushifa A, Jaddel L, Picard C, Ailal F, Gaspar B, Al-HerzW et al. The 2017 IUIS classification for primary immune de-ficiencies. J Clin Immunol 2018;38:129-143 16.Greco A, Rizzo MI, De Virgilio A, Gallo A, Fusconi M, Ru-oppolo G. Churg-Strauss syndrome. Autoimmun Rev. 2015Apr;14(4):341-8 17.Mouthon L, Dunogue B, Guillevin L. Diagnosis and classifi-cation of eosinophilic granulomatosis with polyangiitis (for-merly named Churg-Strauss syndrome). J Autoimmun. 2014Feb-Mar;48-49:99-103 18.Kılıç M. Alerjik eozinofilik özofajit ve gastroenterit. ŞekerelB (eds) Çocukluk Çağında Alerji Astım İmmünoloji. Ankara:Ada Basın Yayın; 2015; 645-655 19.Patel RV, Hirano I. New developments in the diagnosis, the-rapy and monitoring eosinophilic esophagitis. Curr Treat Op-tions Gastro DOI 10.1007/s11938-018-0167-1