Helmut J F Salzer1, Thierry Rolling2, Christof D Vinnemeier3, Egbert Tannich4, Stefan Schmiedel5, Marylyn M Addo6, Jakob P Cramer7. 1. Sections of Infectious Diseases and Tropical Medicine, I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Division of Clinical Infectious Diseases and German Center for Infection Research Tuberculosis Unit, Research Center Borstel Borstel, Germany. Electronic address: hsalzer@fz-borstel.de. 2. Sections of Infectious Diseases and Tropical Medicine, I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Clinical Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany. Electronic address: t.rolling@uke.de. 3. Sections of Infectious Diseases and Tropical Medicine, I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Clinical Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany. Electronic address: vinnemeier@bnitm.de. 4. Department of Molecular Parasitology, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany; National Reference Centre for Tropical Infections, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany. Electronic address: tannich@bnitm.de. 5. Sections of Infectious Diseases and Tropical Medicine, I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: s.schmiedel@uke.de. 6. Sections of Infectious Diseases and Tropical Medicine, I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: m.addo@uke.de. 7. Department of Clinical Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany. Electronic address: jakob.cramer@takeda.com.
Abstract
OBJECTIVES: Eosinophilia in travelers and migrants returning from the tropics is often associated with invasive helminthic infections. Total IgE is considered a useful additional diagnostic parameter; however, both parameters are also increased in various other non-helminthic diseases. METHODS: We retrospectively evaluated travelers and migrants seen at our department between September 2007 and May 2014. Patients with an absolute eosinophil count ≥500 cells/μl were considered for further analyses. RESULTS: Among 6618 returned travelers and migrants, 154 (2.3%) had a total eosinophil count ≥500 cells/μL. Of these, 71 patients (46%) were diagnosed with helminthic infection. In an additional 62 patients (40%) with eosinophilia a final diagnosis was found, including non-helminthic infections in 34 patients and non-infectious causes in 28 patients, while in 21 patients (14%) no diagnosis was made. Patients with helminthic infections had higher eosinophil counts than travelers and migrants with other diagnoses (median 981 vs. 710 cells/μl; p = 0.001), while total IgE levels (n = 70; 172 vs. 152 kU/l; p = 0.731) were similar in both groups. CONCLUSION: Eosinophil count but not total IgE levels are associated with helminthic infections in returning travelers and migrants with eosinophilia. Our results do not support the use of total IgE to differentiate helminthic infections from other causes of eosinophilia in this population.
OBJECTIVES:Eosinophilia in travelers and migrants returning from the tropics is often associated with invasive helminthic infections. Total IgE is considered a useful additional diagnostic parameter; however, both parameters are also increased in various other non-helminthic diseases. METHODS: We retrospectively evaluated travelers and migrants seen at our department between September 2007 and May 2014. Patients with an absolute eosinophil count ≥500 cells/μl were considered for further analyses. RESULTS: Among 6618 returned travelers and migrants, 154 (2.3%) had a total eosinophil count ≥500 cells/μL. Of these, 71 patients (46%) were diagnosed with helminthic infection. In an additional 62 patients (40%) with eosinophilia a final diagnosis was found, including non-helminthic infections in 34 patients and non-infectious causes in 28 patients, while in 21 patients (14%) no diagnosis was made. Patients with helminthic infections had higher eosinophil counts than travelers and migrants with other diagnoses (median 981 vs. 710 cells/μl; p = 0.001), while total IgE levels (n = 70; 172 vs. 152 kU/l; p = 0.731) were similar in both groups. CONCLUSION: Eosinophil count but not total IgE levels are associated with helminthic infections in returning travelers and migrants with eosinophilia. Our results do not support the use of total IgE to differentiate helminthic infections from other causes of eosinophilia in this population.
Authors: Namhee Kwon; Emilio Pizzichini; Aruna T Bansal; Frank C Albers; Neil Barnes; John H Rile; Aline Lima-Matos; Eduardo Viera Ponte; Alvaro A Cruz Journal: World Allergy Organ J Date: 2020-05-16 Impact factor: 4.084