M. Brigden et C. Graydon, EOSINOPHILIA DETECTED BY AUTOMATED BLOOD-CELL COUNTING IN AMBULATORY NORTH-AMERICAN OUTPATIENTS - INCIDENCE AND CLINICAL-SIGNIFICANCE, Archives of pathology and laboratory medicine, 121(9), 1997, pp. 963-967
Citations number
45
Categorie Soggetti
Pathology,"Medical Laboratory Technology","Medicine, Research & Experimental
Objectives.-To audit a cohort of ambulatory outpatients with eosinophi
lia detected on automated blood cell counting. Specific objectives inc
luded the determination of whether the eosinophilia had been anticipat
ed, the etiology of the eosinophilia, the clinical follow-up and inves
tigations performed on patients with eosinophilia, and the effect of t
he detection of eosinophilia on patient management and ultimate clinic
al outcome. Design.-A year-long retrospective review of all patients w
ith an absolute eosinophil count of greater than 0.7 x 10(9)/L. Settin
g.-A large outpatient laboratory system. The patient population was ma
naged by family physicians and specialists. Intervention.-Data collect
ion included the results of the hematology profile, the absolute eosin
ophil count, the clinical situation responsible for the hematologic pr
ofile determination, and the probable cause of eosinophilia. Individua
l physicians were surveyed to determine if discovery of the eosinophil
ia had changed patient management plan or clinical outcome. Principal
Results.-Out of 195 300 patients who had a hematology profile performe
d, 225 were found to have an absolute eosinophilia count higher than 0
.7 x 109/L. The overall incidence of eosinophilia in the study populat
ion was 0.1%. The eosinophilia was not anticipated in 85% of patients.
No obvious cause was detected for the eosinophilia in 36% of patients
. Various allergic diseases were responsible for the eosinophilia in t
he majority of the remaining patients. Fewer than 9% of individuals ma
nifested a serious systemic illness or parasitemia. Further clinical f
ollow-up had been performed in 69% of patients. Additional laboratory
tests had been ordered in 59% of patients. The laboratory tests most f
requently ordered were a repeat hematology profile or stool examinatio
ns for ova and parasites. In only two instances did the discovery of t
he eosinophilia appear to result in a significant change in patient ma
nagement or ultimate clinical income. Conclusion.-The vast majority of
eosinophilias detected in ambulatory outpatients are associated with
allergic processes. An extensive investigation of eosinophilia in ambu
latory North American outpatients does not appear to be warranted unle
ss specifically indicated by the results of the history and physical e
xamination.