BANCROFTIAN LYMPHADENOPATHY - ABSENCE OF EOSINOPHILS IN TISSUES DESPITE PERIPHERAL-BLOOD HYPEREOSINOPHILIA

We studied the association of eosinophils with Wuchereria bancrofti pa rasites in two children with biopsy-proven filarial lymphadenopathy an d peripheral blood hypereosinophilia. In both cases, intact adult worm s were present in lymph nodes but no inflammatory reaction was observe d. The most remarkable histological feature in our patients was the ab sence of eosinophils in tissue sections in spite of persistently high numbers of eosinophils in peripheral blood. In the first case, treatme nt of intestinal parasites before lymph node excision promptly reduced eosinophil counts to normal levels even though levels of micrifilarae mia remained virtually unchanged. In the second patient, hypereosinoph ilia persisted after lymph node resection but disappeared following cu rative treatment of intestinal helminths. These observations raise fun damental questions about the causal relationship and the role of eosin ophils in lymphatic filariasis.