What Are the Causes of Eosinophilia in Children?

Pediatric tropical eosinophilia is a clinical syndrome mainly manifested by eosinophilia. This type of eosinophilia is related to some tropical diseases, mainly parasitic diseases and parasitic infections. , Is a type of pulmonary eosinophilia.

Basic Information

English name: Tropical Eosinophilia
Visiting department: Pediatrics
Common locations: Blood, tissue, organ

Common causes: Related to parasitic diseases and parasitic infections
Common symptoms: Fever, burnout, fatigue, general malaise, headache, chest pain, cough; severe asthma, or hemoptysis

Causes of tropical eosinophilia in children

The following pathogens are more certain: parasitic infections, respiratory infections (including bacterial infections, viral infections and fungal infections), various pollen, drugs (such as penicillin, sulfa drugs, p-salicylic acid, tryptophan, etc.) and smoke, Dust, animal waste, etc. Among the causes of pulmonary eosinophilia, parasitic infection is the most common. Infection with roundworms and hookworms can cause simple pulmonary eosinophilia (Löffer syndrome); larval infections of jaw-mouth nematodes, trematodes, toxocara, and angiostrongylus can cause persistent eosinophilia; The most typical tropical eosinophilia is caused by cryptofilariasis. In addition to the above parasites, various helminth infections such as clonorchiasis, schistosomiasis, ginger leafworm, liver fluke, tapeworm, tapeworm, whipworm, trichinella, pigworm, and filariasis can be accompanied by eosinophils increase.

Clinical manifestations of tropical eosinophilia in children

Tropical eosinophilia usually has no clear incubation period, and the onset is generally slow. Those with mild response may have no obvious symptoms. Patients may have fever, burnout, fatigue, general discomfort, headache, chest pain and other cold-like symptoms. There may also be cough, but less sputum, and occasionally bloodshot sputum. In severely infected people, asthma and hemoptysis can also occur. Respiratory sounds were weakened in a few patients, and dullness in lung percussion was dull.

The clinical symptoms of tropical eosinophilia caused by filariasis are obvious, and the course can be as long as 3 years or more. Typical cases can be paroxysmal dry cough, asthma, dyspnea, and exacerbation at night. Whispers and wet and dry murmurs can be heard in both lungs. Patients with tropical eosinophilia may be accompanied by lymphadenopathy and hepatomegaly, and some patients may have pulmonary dysfunction. The course of simple acidocytosis caused by hookworms and tapeworms is generally within 1 month, and can heal without treatment. The course of acidocytosis caused by visceral larva migrans is 2 to 6 months or longer. The prognosis of eosinophilia caused by parasite infection is good.

Pediatric tropical eosinophilia test

Blood test

The total number of white blood cells in peripheral blood increased, often> 10 × 10 / L. Eosinophils can range from 20% to 80% and very few exceed 90%. The absolute value of eosinophils in most patients is above 0.4 × 10 / L, and a few can reach (2.0 3.0) × 10 / L More. Increased serum IgE.

2. Immunological test

Microfilariae in blood are generally difficult to detect. Serum anti-filariatic antibodies were mostly positive. Eggs such as roundworm eggs can be found in the stool of some patients. Allergen skin tests may show an allergic reaction to certain allergens.

3. stool test

If you suspect an intestinal parasitic infection, you should check your stool carefully for eggs. If the eggs are positive, you can confirm the diagnosis. However, in the early stage of intestinal parasitic infection or parasitic infection that only causes larval migrans, no eggs can be found in the stool. Corresponding immunological tests should be performed. Anti-parasitic antibodies should be positive.

4.X-ray inspection

X-ray examination of the lungs can show increased lung texture, thickening, and disorder. The density is generally low. It often appears in the Ueno near the pleura as small or large patches with blurred edges. It can be migratory and can range from 1 to It disappears within 2 weeks, and chronic patients can continue for a long time.

Diagnosis of tropical eosinophilia in children

Peripheral blood eosinophils increased significantly, and IgE levels increased. If an intestinal parasite infection is suspected, the stool can be diagnosed with positive eggs. However, no worm eggs can be found in the stool. Corresponding immunological tests should be performed. Anti-parasite antibodies should be positive to help confirm the diagnosis. The diagnosis can be confirmed based on clinical symptoms, hemogram, X-ray examination, immunological test results, combined medical history and local parasitic disease epidemic.

Differential diagnosis of tropical eosinophilia in children

A detailed medical history inquiry and physical examination should be performed, especially on the skin, liver, spleen, lymph nodes, and cardiovascular system to exclude skin lesions, eosinophilic leukemia, bone eosinophilic granuloma, and familial eosinophils Cytocytosis, nodular polyarteritis, etc., bone marrow aspiration is of diagnostic value for eosinophilic leukemia, for some unknown causes, involving one or more organs, and eosinophilic diseases with diverse symptoms and signs Sometimes differential diagnosis is often difficult, and the final diagnosis depends on tissue biopsy. X-ray changes of the lung should be distinguished from lung infections such as pneumonia and tuberculosis.

Pediatric tropical eosinophilia treatment

Severe cases can be treated with adrenocortical hormones to control symptoms and perform symptomatic treatment. For filariasis infection, ethamazine can be used; eosinophilia caused by migration of other parasite larvae can be treated with albendazole.

Prognosis of tropical eosinophilia in children

If the cause is related to the drug, stop the drug in time; the parasite-causing person should drive the worm, etc., which can often make the disease recover quickly, and most of them have a good prognosis.

Prevention of tropical eosinophilia in children

To prevent parasite infection, you should develop good hygiene habits, cut your nails frequently, wash your hands before meals, do not eat unclean food, do not drink raw water, and avoid contact with soil and sewage to prevent parasites from infecting the human body through the mouth or skin. Strengthen management of human and animal manure.