소아 호산구 증가증의 원인과 빈도: 1년간 단일 기관 연구

김경민 ( Kyung Min Kim ),배미혜 ( Mi Hye Bae ),김영미 ( Young Mi Kim ),조민정 ( Min Jung Cho ),곽민정 ( Min Jung Kwak ),김성헌 ( Seong Heon Kim ),손승국 ( Seung Kook Son ),박희주 ( Hee Ju Park ),김혜영 ( Hye Young Kim ) 대한천식알레르기학회 2014 Allergy Asthma & Respiratory Disease Vol.2 No.5

Purpose: Eosinophilia may be associated with various primary and reactive conditions. However, studies on the cause and incidence of eosinophilia in Korean children are rare. This study aimed to evaluate the cause and incidence of eosinophilia in patients at a single university hospital. Methods: We studied 8,285 pediatric patients under the age of 18 years who had eosinophilia at Pusan National University Hospital. Premature and newborn infants were excluded. Eosinophilia was defined as an absolute eosinophil count greater than 450/μL. Eosinophilia was categorized as mild (450-1,500/μL), moderate (1,500-5,000/μL), and severe (>5,000/μL). The underlying conditions of eosinophilia were retrospectively investigated. Results: Of 8,285 patients who had a hematology profile, 497 (5.9%) were found to have eosinophilia. Of patients with eosinophilia, 333 patients (67.0%) had identifiable and possible causes. The major causes of eosinophilia were allergic diseases (61.3%), infectious diseases (19.8%), immunologic diseases (9.0%) and hemato-oncologic disease (5.1%). Immunological disease such as Idiopathic hypereosinophilic syndrome, drug induced hypersensitivity syndrome and Graft-versus-host disease was the common condition with moderate to severe eosinophilia in which eosinophil count in peripheral blood was more than 1,500/μL. Conclusion: The most common cause of eosinophilia was allergic disease. Immunological disease was the common condition with moderate to severe eosinophilia.(Allergy Asthma Respir Dis 2014;2:358-361)

Peripheral Eosinophilia and Clinico-radiological Characteristics among Health Screening Program Recipients

( Tae Yun Park ),( Jae-woo Jung ),( Ju Young Jang ),( Jae Chol Choi ),( Jong Wook Shin ),( In Won Park ),( Byoung Whui Choi ),( Jae Yeol Kim ) 대한결핵 및 호흡기학회 2018 Tuberculosis and Respiratory Diseases Vol.81 No.2

Background: Eosinophilia is well recognized in specific conditions. The objective of the present study was to determine clinico-radiologic characteristics of eosinophilia and changes in prevalence over 10 years in recipients of private health screening program at a tertiary hospital in Korea. Methods: Data of private health screening program recipients at the health promotion center of Chung-Ang University Hospital from 2004 to 2013 were collected. Health-related questionnaires and laboratory findings of private health screening program with possible relation with eosinophilia were reviewed. Results of enzyme-linked immunosorbent assay (ELISA) for parasite, chest computed tomography, and pulmonary function test were also reviewed. Results: The cumulative prevalence of eosinophilia was 4.0% (1,963 of 48,928). Prevalence of eosinophilia showed a decreased trend from 2004 to 2013. Most cases (96.6%) had mild degree of eosinophilia. Eosinophilic subjects were older and male-predominant. They showed lower levels of forced expiratory volume in 1 second (FEV₁%), forced vital capacity (FVC%), and FEV₁/FVC than those without eosinophilia. Eosinophilic subjects showed higher positive rate for common parasite in ELISA than those without eosinophilia. On radiologic findings, consolidation and ground glass opacities were positively associated with the degree of eosinophilia. When eosinophil was classified based on severity, statistically significant correlation between the severity of eosinophil and radiologic abnormalities was found. Conclusion: Eosinophilia is uncommon in healthy population. It usually occurs at a mild degree. Eosinophilic patients have more radiologic abnormalities compared to those without eosinophilia. Such radiologic abnormalities are associated with the severity of eosinophilia.

Evaluation of the prevalence and clinical impact of toxocariasis in patients with eosinophilia of unknown origin

( Hong-beum Kim ),( Jun-won Seo ),( Jun-hyung Lee ),( Byung-seok Choi ),( Sang-gon Park ) 대한내과학회 2017 The Korean Journal of Internal Medicine Vol.32 No.3

Background/Aims: Eosinophilia has numerous diverse causes, and in many patients, it is not possible to establish the cause of eosinophilia. Recently, toxocariasis was introduced as one cause of eosinophilia. The aims of this study were to evaluate the prevalence of toxocariasis and the clinical impact of albendazole treatment for toxocariasis in patients suspected of eosinophilia of unknown origin. Methods: We performed a retrospective chart review. After evaluation of cause of eosinophilia, the patients suspected of eosinophilia of unknown origin performed immunoglobulin G antibody specific assay for the Toxocara canis larval antigen by enzyme-linked immunosorbent assay. Results: This study evaluated 113 patients, 69 patients (61%) were suspected of eosinophilia of unknown origin. Among these 69 patients, the frequency of T. canis infection was very high (45 patients, 65.2%), and albendazole treatment for 45 eosinophilia with toxocariasis was highly effective for a cure of eosinophilia than no albendazole group regardless of steroid (82.3%, p = 0.007). Furthermore, among the nonsteroid treated small group (19 patients), albendazole treatment for eosinophilia were more effective than no albendazole group, too (83.3% vs. 28.6 %, p = 0.045). Conclusions: The prevalence of toxocariasis was high among patients suspected of eosinophilia of unknown origin; therefore, evaluation for T. canis infection is recommended for patients with eosinophilia of unknown origin. Furthermore, for patients suspected of eosinophilia of unknown origin who have positive results for T. canis, albendazole treatment may be considered a valuable treatment option.

신생아 집중 치료실에서 호산구 증가증 원인에 관한 분석

김정영,임효빈,성민정,손상희,서손상 대한소아청소년과학회 2010 Clinical and Experimental Pediatrics (CEP) Vol.53 No.1

Purpose:Although eosinophilia is a common laboratory finding in many neonatal intensive care units (ICUs), its causative mechanisms remain obscure. We aimed to determine the causes of eosinophilia in the neonatal ICU environment. Methods:Serial eosinophil counts were determined weekly for 288 hospitalized, appropriately grown neonates. Infants were divided into four groups according to gestational age, and the incidence and etiologic factors of eosinophilia were retrospectively studied. Results:Absolute eosinophilia (>700/mm3) was documented in 18% (52/288) of neonates. Twenty-two infants (42.3%) exhibited mild eosinophilia (700-999 cells/mm3), 27 (51.9%) exhibited moderate eosinophilia (1,000–2,999 cells/mm3), and 3 (5.8%) exhibited severe eosinophilia (>3,000 cells/mm3). Of the 288 infants studied, 54 suffered sepsis. Thirty of these 54 infants (55.6%) showed eosinophilia, and 22 out of the remaining 234 infants (9%) without sepsis showed eosinophilia, indicating that eosinophilia was more prevalent in the sepsis group (P<0.05). All 5 infants suffering from bronchopulmonary dysplasia showed eosinophilia, and 47 out of the remaining 283 infants (16.7%) without bronchopulmonary dysplasia showed eosinophilia. Thus, eosinophilia was more prevalent in the bronchopulmonary dysplasia group (P<0.05). Furthermore, increased prevalence of eosinophilia was associated with respiratory distress syndrome, ventilator use, blood transfusion, and total parenteral nutrition (P<0.05). Conclusion:Our results suggest that eosinophilia is influenced by sepsis and bronchopulmonary dysplasia, although it can also occur idiopathically at birth. Moreover, the potential role of eosinophils in conditions such as wound healing and fibrosis in sepsis or chronic lung disease may be a cause of eosinophilia. 목적:신생아 호산구증가증은 전혈검사 상 흔하게 발견되지만 아직 정확한 원인은 규명되지 않고 있어 호산구증가증의 빈도와 원인을 확인하기위해 신생아 중환자실에 입원한 환아들을 대상으로 후향적으로 연구를 시행하였다. 방법:2006년 1월부터 12월까지 부산 좋은 문화병원에서 신생아 중환자실에 입원한 환아 전체를 대상으로 31주 미만, 31주 이상부터 34주 미만, 34주 이상부터 37주 미만, 37주 이상의 네 군으로 나누어 출생당일과 그 후 일주일 간격으로 최대 4주간 절대 호산구치를 측정하여 호산구증가군과 호산구정상군을 비교하였다. 결과:전체 대상 환아 288명 중 52명에서 호산구증가증(>700/mm3)이 발생하여 18%의 발생률을 보였다. 경증 호산구증은 22명(42.3%), 중등증 호산구증은 27명(51.9%), 중증 호산구증은 3명(5.8%) 발생하였다. 패혈증군 54명 중 30명(55.6 %)이 호산구증가증을 보였고 비패혈증군 234명 중 22(9%)명이 호산구증가증을 보였다. 패혈증 발생률이 높은 군에서 호산구증가증이 유의하게 증가하였다(P<0.05). 만성폐질환이 발생한 5명 중 5명(100%) 모두 호산구증가증이 발생하였고, 만성폐질환이 발생하지 않은 283명 중 47명(16.7%)이 호산구증가증을 보였다. 만성폐질환 발생군에서 호산구증가증이 유의하게 호발하였다(P<0.05). 그 외 신생아 호흡곤란증, 인공호흡기 사용, 수혈, 정맥 내 영양을 한 군에서 호산구증가증이 호발하였다. 결론:본 연구에서 호산구증가증은 감염 후나 만성폐질환 시 호산구증가증이 발생하였다. 또한 출생 초기 특발성으로 발생하기도 하였다. 패혈증이나 만성폐질환 시 상처 재생과 섬유화에 관여하는 호산구의 잠재적 기능이 호산구증가증의 원인으로 사료된다.

Peripheral Eosinophilia and Clinico-radiological Characteristics among Health Screening Program Recipients

Park, Tae Yun,Jung, Jae-Woo,Jang, Ju Young,Choi, Jae Chol,Shin, Jong Wook,Park, In Won,Choi, Byoung Whui,Kim, Jae Yeol The Korean Academy of Tuberculosis and Respiratory 2018 Tuberculosis and Respiratory Diseases Vol.81 No.2

Background: Eosinophilia is well recognized in specific conditions. The objective of the present study was to determine clinico-radiologic characteristics of eosinophilia and changes in prevalence over 10 years in recipients of private health screening program at a tertiary hospital in Korea. Methods: Data of private health screening program recipients at the health promotion center of Chung-Ang University Hospital from 2004 to 2013 were collected. Health-related questionnaires and laboratory findings of private health screening program with possible relation with eosinophilia were reviewed. Results of enzyme-linked immunosorbent assay (ELISA) for parasite, chest computed tomography, and pulmonary function test were also reviewed. Results: The cumulative prevalence of eosinophilia was 4.0% (1,963 of 48,928). Prevalence of eosinophilia showed a decreased trend from 2004 to 2013. Most cases (96.6%) had mild degree of eosinophilia. Eosinophilic subjects were older and male-predominant. They showed lower levels of forced expiratory volume in 1 second ($FEV_1%$), forced vital capacity (FVC%), and $FEV_1/FVC$ than those without eosinophilia. Eosinophilic subjects showed higher positive rate for common parasite in ELISA than those without eosinophilia. On radiologic findings, consolidation and ground glass opacities were positively associated with the degree of eosinophilia. When eosinophil was classified based on severity, statistically significant correlation between the severity of eosinophil and radiologic abnormalities was found. Conclusion: Eosinophilia is uncommon in healthy population. It usually occurs at a mild degree. Eosinophilic patients have more radiologic abnormalities compared to those without eosinophilia. Such radiologic abnormalities are associated with the severity of eosinophilia.

Peripheral Eosinophilia and Clinico-radiological Characteristics among Health Screening Program Recipients

박태윤,정재우,장주영,최재철,신종욱,박인원,최병휘,김재열 대한결핵및호흡기학회 2018 Tuberculosis and Respiratory Diseases Vol.81 No.2

Background: Eosinophilia is well recognized in specific conditions. The objective of the present study was to determine clinico-radiologic characteristics of eosinophilia and changes in prevalence over 10 years in recipients of private health screening program at a tertiary hospital in Korea. Methods: Data of private health screening program recipients at the health promotion center of Chung-Ang University Hospital from 2004 to 2013 were collected. Health-related questionnaires and laboratory findings of private health screening program with possible relation with eosinophilia were reviewed. Results of enzyme-linked immunosorbent assay (ELISA) for parasite, chest computed tomography, and pulmonary function test were also reviewed. Results: The cumulative prevalence of eosinophilia was 4.0% (1,963 of 48,928). Prevalence of eosinophilia showed a decreased trend from 2004 to 2013. Most cases (96.6%) had mild degree of eosinophilia. Eosinophilic subjects were older and male-predominant. They showed lower levels of forced expiratory volume in 1 second (FEV1%), forced vital capacity (FVC%), and FEV1/FVC than those without eosinophilia. Eosinophilic subjects showed higher positive rate for common parasite in ELISA than those without eosinophilia. On radiologic findings, consolidation and ground glass opacities were positively associated with the degree of eosinophilia. When eosinophil was classified based on severity, statistically significant correlation between the severity of eosinophil and radiologic abnormalities was found. Conclusion: Eosinophilia is uncommon in healthy population. It usually occurs at a mild degree. Eosinophilic patients have more radiologic abnormalities compared to those without eosinophilia. Such radiologic abnormalities are associated with the severity of eosinophilia.

임상 ; 극소 저체중 출생아에서 혈구세포의 변화와 호산구 증가증에 대한 연구

한지연 ( Ji Yeon Han ),길태환 ( Tae Hwan Kil ),윤정민 ( Jung Min Yoon ),김준범 ( June Bum Kim ),고경옥 ( Kyong Og Ko ),이영혁 ( Young Hyuk Lee ),임재우 ( Jae Woo Lim ) 대한주산의학회 2011 Perinatology Vol.22 No.4

목적 : 정상 신생아에서 혈구세포의 변화나 호산구증가증에 대한 연구는 일부 보고된 바가 있지만, 극소 저체중 출생아에서의 혈구세포의 변화와 호산구증가증과의 연관성에 대한 연구는 국내에서 아직 보고된 바가 없다. 이에 본 연구에서는 극소 저체중 출생아에서 생후 한 달간 혈구 세포들의 변화양상과 호산구증가증의 관련인자들에 대해서 알아보았다. 방법 : 2003년 3월부터 2010년 5월까지 건양대학교병원 신생아중환아실에 4주 이상 입원하였던 출생체중 1,500 g 미만의 극소 저체중 출생아 141명을 대상으로 하였다. 출생 첫 날, 생후 3일, 7일, 14일, 21일, 28일 째의 일반혈액검사 수치를 기초로 혈구세포의 변화양상과 평균치를 분석하였고, 호산구증가증과 관련된 산모 및 환아의 인자들을 후향적으로 조사하였다. 호산구증가증은 호산구수가 700/mm3 이상 증가된 경우로 정의하였다. 결과 : 대상 환아들 중 50.4%가 생후 첫 한 달 동안 적어도 1회 이상의 호산구증가증을 보였다. 이를 세분화하였을 때 경증 호산구증은 19명(26.8%), 중등증 호산구증은 36명(50.7%), 중증 호산구증은 16명(22.5%)으로 나타났다. 극소 저체중 출생아에서 혈구수와 절대중성구수는 출생 후부터 생후 7일 경까지 증가추세를 보이다가 이후 감소한 반면, 호산구수는 재태연령이나 출생체중에 관계없이 생후 21일 경에 최고치를 보였다. 주산기 특성 및 환아의 관련 인자에 따른 호산구증가증 발생위험도를 알아보기 위해 호산구증가증 유무로 나누어 두 군 간 비교를 한 결과, 호산구증가증이 가장 호발하였던 생후 21일에 출생체중과 총정맥영양, 생후 28일에 총정맥영양과 수혈이 호산구증가증의 발생과 통계적유의성을 보였으며, 로지스틱 회귀분석에서는 수혈 횟수가 증가할수록 호산구증가증이 통계적으로 유의하게 호발하였다(P<0.05). 결론 : 극소 저체중 출생아에서 호산구증가증은 생후 21일 경에 호발하였으며, 호산구수의 변화는 백혈구수나 절대중성구수의 변화와 다른 양상을 보였다. 호산구수의 증가는 주로 수혈과 관계가 있었다. Purpose : This study investigated the pattern of hematologic profile and eosinophilia for a month after birth in very low birth weight (VLBW) infants. Methods : The medical records of 141 VLBW infants (birth weight, <1,500 g) admitted to the neonatal intensive care unit (NICU) of Konyang University Hospital. We collected complete blood cell counts (CBC) weekly for 4 weeks and studied hematologic profile and related factors of eosinophilia (≥700/mm3). Results : Overall, 50.4% of all infants had at least one instance of eosinophilia for a month after birth. There were 50.7% with moderate eosinophilia (1,000-2,999/mm3). White blood cell (WBC) counts and absolute neutrophil count (ANC) climaxed on 7th day of life, whereas eosinophilia mainly occurred on 21st day of life. The demographic data and perinatal characteristics of infants with and without eosinophilia were compared. Prevalence of eosinophilia was associated with gestational age and total parenteral nutrition on 21st day of life; total parenteral nutrition and transfusion on 28th day of life. Eosinophilia was closely associated with transfusion on logistic regression analysis (P<0.05). Conclusion : Eosinophilia in VLBW infants occurs mainly on 21st day of life. Eosinophil counts showed a separate trend different from WBC counts and ANC. Transfusion was significantly associated with eosinophilia.

The relationship between eosinophilia and bronchopulmonary dysplasia in premature infants at less than 34 weeks' gestation

Yang, Joo Yun,Cha, Jihei,Shim, So-Yeon,Cho, Su Jin,Park, Eun Ae The Korean Pediatric Society 2014 Clinical and Experimental Pediatrics (CEP) Vol.57 No.4

Purpose: Eosinophilia is common in premature infants, and its incidence increases with a shorter gestation period. We investigated the clinical significance of eosinophilia in premature infants born at <34 weeks gestation. Methods: We analyzed the medical records of premature infants born at <34 weeks gestation who were admitted to the neonatal intensive care unit at Ewha Womans University Mokdong Hospital between January 2003 and September 2010. Eosinophilia was defined as an eosinophil percentage of >3% of the total leukocytes. Perinatal parameters and clinical parameters were also analyzed. Results: Of the 261 infants born at <34 weeks gestation, 22.4% demonstrated eosinophilia at birth. The eosinophil percentage peaked in the fourth postnatal week at 7.5%. The incidence of severe eosinophilia increased after birth up to the fourth postnatal week when 8.8% of all patients had severe eosinophilia. Severity of eosinophilia was positively correlated with a lower gestational age, birth weight, and Apgar score. Respiratory distress syndrome, bronchopulmonary dysplasia, nephrocalcinosis, intraventricular hemorrhage, and sepsis were associated with a higher eosinophil percentage. The eosinophil percentage was significantly higher in infants with bronchopulmonary dysplasia from the first postnatal week and the percentage was the highest in the fourth postnatal week, with the maximal difference being 4.1% (P<0.001). Conclusion: Eosinophilia is common in premature infants and reaches peak incidence and severity in the fourth postnatal week. The eosinophil percentage was significantly higher in bronchopulmonary dysplasia patients from the first postnatal week. Severe eosinophilia was significantly associated with the incidence of bronchopulmonary dysplasia even after adjusting for other variables.

Prevalence of Toxocariasis and Its Risk Factors in Patients with Eosinophilia in Korea

송현범,이덕호,Yan Jin,Jinwoo Kang,조신형,박민선,박진호,송우정,강혜련,이상협,홍성태,최민호 대한기생충학ㆍ열대의학회 2020 The Korean Journal of Parasitology Vol.58 No.4

Eosinophilia occurs commonly in many diseases including allergic diseases and helminthic infections. Toxocariasis has been suggested as one cause of eosinophilia. The present study was undertaken to examine the prevalence of toxocariasis in patients with eosinophilia and to identify the risk factors for toxocariasis. This prospective cohort study recruited a total of 81 patients with eosinophilia (34 males and 47 females) who visited the outpatient clinic at Seoul National University Hospital from January 2017 to February 2018 and agreed to participate in this study. The prevalence of toxocariasis was examined by T. canis-specific ELISA, and the various risk factors for toxocariasis were evaluated by a questionnaire survey. Among 81 patients with eosinophilia, 18 were positive for anti-T. canis antibodies (22.2%); 88.9% were male (16/18) and 11.1% were female (2/18). Multivariate statistical analysis revealed that males (OR 21.876, 95% CI: 1.667–287.144) with a history of consuming the raw meat or livers of animals (OR 5.899, 95% CI: 1.004–34.669) and a heavy alcohol-drinking habit (OR 8.767, 95% CI: 1.018–75.497) were at higher risk of toxocariasis in patients with eosinophilia. Toxocariasis should be considered a potential cause of eosinophilia when the patient has a history of eating the raw meat or livers of animals in Korea. A single course of albendazole is recommended to reduce the migration of Toxocara larvae in serologically positive cases with eosinophilia.

The relationship between eosinophilia and bronchopulmonary dysplasia in premature infants at less than 34 weeks’ gestation

양주윤,차지혜,심소연,조수진,박은애 대한소아청소년과학회 2014 Clinical and Experimental Pediatrics (CEP) Vol.57 No.4

Purpose: Eosinophilia is common in premature infants, and its incidence increases with a shorter gestationperiod. We investigated the clinical significance of eosinophilia in premature infants born at <34weeks gestation. Methods: We analyzed the medical records of premature infants born at <34 weeks gestation whowere admitted to the neonatal intensive care unit at Ewha Womans University Mokdong Hospital betweenJanuary 2003 and September 2010. Eosinophilia was defined as an eosinophil percentage of >3% ofthe total leukocytes. Perinatal parameters and clinical parameters were also analyzed. Results: Of the 261 infants born at <34 weeks gestation, 22.4% demonstrated eosinophilia at birth. The eosinophil percentage peaked in the fourth postnatal week at 7.5%. The incidence of severe eosinophiliaincreased after birth up to the fourth postnatal week when 8.8% of all patients had severe eosinophilia. Severity of eosinophilia was positively correlated with a lower gestational age, birth weight,and Apgar score. Respiratory distress syndrome, bronchopulmonary dysplasia, nephrocalcinosis,intraventricular hemorrhage, and sepsis were associated with a higher eosinophil percentage. Theeosinophil percentage was significantly higher in infants with bronchopulmonary dysplasia from thefirst postnatal week and the percentage was the highest in the fourth postnatal week, with the maximaldifference being 4.1% (P<0.001). Conclusion: Eosinophilia is common in premature infants and reaches peak incidence and severity inthe fourth postnatal week. The eosinophil percentage was significantly higher in bronchopulmonarydysplasia patients from the first postnatal week. Severe eosinophilia was significantly associated withthe incidence of bronchopulmonary dysplasia even after adjusting for other variables.