New diagnostic tool for differentiation of idiopathic hypereosinophilic syndrome (HES) and secondary eosinophilic states

• Published in: Pathology oncology research Vol. 7; no. 4; pp. 292 - 297
• Main Authors: Berki, T, Dávid, M, Bóné, B, Losonczy, H, Vass, J, Németh, P
• Format: Journal Article
• Language: English
• Published: Netherlands Springer Nature B.V 2001
• Subjects: Adolescent; Adult; Aged; Blood Proteins - metabolism; CD3 antigen; CD4 antigen; CD4-Positive T-Lymphocytes - immunology; CD56 antigen; CD8 antigen; CD8-Positive T-Lymphocytes - immunology; Cell culture; Cell surface; Clear cells; Differential diagnosis; Eosinophil Granule Proteins; Eosinophilia; Eosinophilia - diagnosis; Eosinophilia - immunology; Eosinophils - immunology; Female; Flow Cytometry; Helper cells; Humans; Hypereosinophilic Syndrome - diagnosis; Hypereosinophilic Syndrome - immunology; Immunoglobulin E - blood; Immunology; Interferon-gamma - metabolism; Interleukin 5; Interleukin-5 - metabolism; Leukocytes (eosinophilic); Life span; Lymphocytes; Lymphocytes T; Male; Medical diagnosis; Middle Aged; Oncology; Pathology; Peripheral blood mononuclear cells; Ribonucleases; Surface markers; T-cell lymphoma
• ISSN: 1219-4956; 1532-2807
• DOI: 10.1007/BF03032386

The hypereosinophilic syndrome (HES) is a very rare disease, characterized by persistent eosinophilia with tissue involvement and organ dysfunction which often precedes a subsequent T cell lymphoma. Interleukin-5 secreted by a T lymphocyte subpopulation has been described in previous reports as the most important factor responsible for the prolonged lifespan of the eosinophils. The goal of the present study was to describe a fast, simple diagnostic method for the differentiation of HES and secondary eosinophilic states. Beside the surface marker analysis of peripheral blood mononuclear cells (PBMC) we measured surface bound IgE molecules on lymphocytes and eosinophil cells, intracellular cytokines (IL-5, INFgamma) in CD4+ lymphocytes and eosinophil major basic protein (MBP) in eosinophils using flow cytometric detection method. The appearance of an IL-5 producing cell population with a decreased number of INFgamma positive lymphocytes was characteristic for the blood samples of HES patients. Predominance of Th2 cells with the appearance of a CD8+/CD3 /CD56+ cell population was restricted for the HES cases and could not be detected in secondary eosinophilic individuals. Our flow cytometric cytokine detection method (with parallel cell surface marker analysis) does not require cell separation or long term cell culture steps previously described for the detection of IL-5 producing cells. Therefore it seems to be a more appropriate approach for the differential diagnosis of primary and secondary eosinophilic states.