Eosinophilia Treatment

Treatment for eosinophilia are based on their identify causes, whether it is an allergy, a medicine reaction, or a parasitic infection. These treatments are usually effective, and fairly non-toxic. Allergic and connective tissue disorders may be amenable to corticosteroid treatment. Parasitic and fungal infections can be worsened or disseminated by use of steroids and should be ruled out if they are indicated by patient history.

In patients with primary eosinophilia without organ involvement, no treatment may be necessary. Cardiac function should be evaluated at regular intervals, however, since peripheral eosinophilia does not necessarily correlate with organ involvement. Steroid responsiveness should be evaluated, both for prognosis (steroid-responsive patients do better) and to guide treatment when needed.

Systemic treatment of primary eosinophilia with organ involvement initially include corticosteroids and IFN-alpha for steroid resistant disease. Other agents for steroid resistant disease include hydroxyurea, chlorambucil, vincristine, cytarabine, 2-CdA, and etoposide. These are usually given as chronic maintenance regimens to control organ involvement. In the presence of PDGFRA and PDGFRB mutations imatinib has achieved complete and durable remissions. Nonmyeloablative allogenic hematopoietic stem cell transplantation (HSCT) can also be considered in drug-refractory cases.

Treatment for hypereosinophilic syndrome is oral corticosteroid therapy, usually starting with prednisolone (eg Deltacortril) at single daily doses of 30-60mg. If this is not effective, a chemotherapeutic agent is administered.

As part of treatment physician may also carry out detailed examination of skin, eyes, brain, lymph nodes, heart, liver, spleen, intestine, bone and nervous system.