Étiologies des éosinophilies au CHU de Grenoble et démarche diagnostique pertinente dans ce contexte

Abstract : A blood eosinophilia can be seen in a wide range of diseases, and diagnostic process is often complex. We tried to provide an overview of the etiologies of eosinophilia in Grenoble university hospital, and to evaluate the utility of the exams. We selected all patients with an eosinophilia equal or above 1 G/l, in the internal medicine department and in the infectious disease unit, from 2009 to 2015. We consulted clinical, biological data and the diagnostic retained of the 129 women and 169 men selected. A diagnosis was found for 118 of them (39,6%). For 129 others, the eosinophilia was not taken in account (neither mentioned nor written in the patient records). Patients with a skin rash had significantly more often exams performed and diagnosis retained. For those whose eosinophilia was investigated, etiologies were iatrogenic disorders (24,5%), infectious diseases (17,0%), allergies (8,2%), vasculitis (8,2%), autoimmune diseases (6,9%). Malignant blood diseases and eosinophilias related to solid tumors represented 3,1% each. For 25,8% of the patients, no cause was found. Parasitic infections were only frequent among patients who traveled in tropical countries (42,5% of parasitosis). 76 patients had a stool examination, but only 5 parasitosis were found this way. 391 parasitic serologies have been performed in 91 patients, of whom 13 had a real parasitosis. 24 patients had high IgE levels : 6 parasitic infections, 5 vasculitis, 4 allergies. Finally, eosinophilia is very often neglected. Drug related eosinophilias are the major etiology, and parasites are rare among non-travelers. Serological exams and stool examination are efficient tests, but preferably for travelers.
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Master Thesis
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Submitted on : Tuesday, October 3, 2017 - 4:52:46 PM
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Martin Peju. Étiologies des éosinophilies au CHU de Grenoble et démarche diagnostique pertinente dans ce contexte. Médecine humaine et pathologie. 2017. ⟨dumas-01609508⟩

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