SYNDROME RESEMBLING TROPICAL PULMONARY EOSINOPHILIA BUT OF NON-FILARIAL ETIOLOGY - SEROLOGICAL FINDINGS WITH FILARIAL ANTIGENS

Although the tropical pulmonary eosinophilia (TPE) syndrome of filaria l. aetiology has very distinctive clinical and immunological features, its clinical profile is not unique; other helminths sometimes induce similar presentations. We carefully evaluated 7 individuals with non-f ilarial TPE-like syndromes and found that serological tests based on d etection of 'antifilarial' immunoglobulin (Ig) G, IgG4, and IgE antibo dies that are usually considered diagnostic for filarial TPE were equa lly elevated in patients with non-filarial, TPE-like syndromes and wer e therefore unhelpful diagnostically. The apparent reasons were immuno logical hyperresponsiveness of such individuals and the shared (i.e., cross-reactive) antigenicity found in the filarial antigen preparation s used routinely for diagnosis. Because appropriate treatment for thos e different pulmonary eosinophilia conditions requires different drugs and management, and because delay in effective treatment results in s ignificant morbidity in such patients, diagnostic capabilities must be improved by identifying and obtaining unique antigens that can serolo gically discriminate between filarial TPE and other similar, but non-f ilarial, pulmonary eosinophilia syndromes.