Case 41 – update 4

For the start of the case and the first and second updates scroll below (and also look at #teamhaem on Twitter for any relevant comments)…

To summarise – our patient has significant eosinophilia with a non-itchy maculopapular rash, splenomegaly and symptoms of heart failure. He has no peripheral lymhadenopathy. He has weight loss and anorexia. There is no diarrhoea or bleeding. A CXR shows some upper lobe diversion but no focal consolidation or hilar lymphadenopathy. Concerns about a vasculitic process such as eosinophilic granulomatosis with polyangiitis (Churg-Strauss) but ANCA are negative. A skin biopsy confirms an eosinophil infiltrate and no evidence of lymphoma. Urinalysis does not reveal proteinuria or haemoglobinuria.

Our patient is symptommatic from the eosinophilia.

Questions:

  • What haematological causes of eosinophilia do you know? How would you investigate these?
  • What empiric treatment may be needed pending further investigations?

Please reply to us (@TeamHaem) on Twitter and always include #TeamHaem to allow others to follow your comments. Please join in the debate and learn about haematological problems along the way. The case will continue to  evolve over the coming week so keep checking #TeamHaem on Twitter for more information.

Please note – all cases on TeamHaem are entirely fictional to protect patient confidentiality.

TeamHaem are not a position of authority.  It is an educational platform to allow discussion and learning.

About TeamHaem

Online education and discussion about all things haematological
This entry was posted in Laboratory morphology, Myeloproliferative neoplasm, Related to other specialities and tagged , , . Bookmark the permalink.

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