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Eosinophils usually account for less than 7% of the circulating leukocytes. [1] A marked increase in non-blood tissue eosinophil count noticed upon histopathologic examination is diagnostic for tissue eosinophilia. [2] Several causes are known, with the most common being some form of allergic reaction or parasitic infection.
If the cause is unknown, it is specified and called "simple pulmonary eosinophilia". Cardiac damage caused by the damaging effects of eosinophil granule proteins (e.g. major basic protein) is known as Loeffler endocarditis and can be caused by idiopathic eosinophilia or eosinophilia in response to parasitic infection. [12]
Parasites cause eosinophilic pneumonia in three different ways. Parasites can either invade the lungs, live in the lungs as part of their life cycle, or be spread to the lungs by the bloodstream. Eosinophils then migrate to the lungs in order to fight the parasites, and cause eosinophilic pneumonia when they release their contents.
High concentrations of these DNA traps are known to cause cellular damage, as the granules they contain are responsible for the ligand-induced secretion of eosinophilic toxins which cause structural damage. [6] There is evidence to suggest that eosinophil granule protein expression is regulated by the non-coding RNA EGOT. [13]
Parasitic pneumonia is a type of pneumonia caused by parasites. Pneumonia is an inflammatory condition of the lungs, most commonly caused by bacteria or viruses. [ 1 ] Parasites are an uncommon cause of pneumonia, usually affecting immunocompromised individuals or those in underdeveloped countries. [ 2 ]
Angiostrongylus cantonensis is a nematode (roundworm) parasite that causes angiostrongyliasis, an infection that is the most common cause of eosinophilic meningitis in Southeast Asia and the Pacific Basin. [3] The nematode commonly resides in the pulmonary arteries of rats, giving it the common name rat lungworm. [4]
In long-established disease, adult worms lay eggs that can cause inflammatory reactions. The eggs secrete proteolytic enzymes that help them migrate to the bladder and intestines to be shed. The enzymes also cause an eosinophilic inflammatory reaction when eggs get trapped in tissues or embolize to the liver, spleen, lungs, or brain. [16]
Eosinophilia is often prominent in filarial infections. Dead worms may cause chronic abscesses, which may lead to the formation of granulomatous reactions and fibrosis. [citation needed] In the human host, Loa loa larvae migrate to the subcutaneous tissue, where they mature into adult worms in approximately one year, but sometimes up to four ...