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A minimum of 15 eosinophils per high-power field are required to make the diagnosis. Eosinophilic inflammation is not limited to the esophagus alone and does extend through the whole gastrointestinal tract. Profoundly degranulated eosinophils may also be present, as may micro-abscesses and an expansion of the basal layer. [3] [10]
The treatment of lymphocytic esophagitis is still undefined. [5] Treatment either targets symptoms, inflammation or complications. For example, heartburn is a symptom in lymphocytic esophagitis, and proton pump inhibitors , which reduce acidity in the stomach, are consequently used for treatment.
[30] [31] Mepolizumab and benralizumab are other treatment options that target the alpha subunit of the IL-5 receptor, thereby inhibiting its function and reducing the number of developing eosinophils as well as the number of eosinophils leading to inflammation through antibody-dependent cell-mediated cytotoxicity and eosinophilic apoptosis.
No universal treatment guidelines have been established for tropical pulmonary eosinophilia. [3] The antifilarial diethylcarbamazine (6 mg/kg/day in three divided doses [2] for 21 days [8] remains the main therapeutic agent, and is generally well tolerated. Reported side effects include headache, fever, pruritus and gastrointestinal upset. [14]
Eosinopenia is a condition where the number of eosinophils, a type of white blood cell, in circulating blood is lower than normal. [1] Eosinophils are a type of granulocyte and consequently from the same cellular lineage as neutrophils, basophils, and mast cells.
An obsolete treatment is vagotomy ("highly selective vagotomy"), the surgical removal of vagus nerve branches that innervate the stomach lining. This treatment has been largely replaced by medication. Vagotomy by itself tended to worsen contraction of the pyloric sphincter of the stomach, and delayed stomach emptying.
When eosinophilic pneumonia is related to an illness such as cancer or parasitic infection, treatment of the underlying cause is effective in resolving the lung disease. When due to acute or chronic eosinophilic pneumonia, however, treatment with corticosteroids results in a rapid, dramatic resolution of symptoms over the course of one or two days.
Acute eosinophilic pneumonia (AEP) is an uncommon, acute-onset form of eosinophilic lung disease which varies in severity. Though poorly understood, the pathogenesis of AEP likely varies depending on the underlying cause which may include smoking, inhalation exposure, medication, and infection. [ 1 ]