Idiopathic hypereosinophilic syndromes and rare dysimmune conditions associated with hyper-eosinophilia in practice: An innovative multidisciplinary approach

Marco Caminati, MD; Lucia Federica Carpagnano, MD; Chiara Alberti, MSc; Francesco Amaddeo, PhD; Riccardo Bixio, MD; Federico Caldart, MD; Lucia De Franceschi, PhD; Micol Del Giglio, PhD; Giuliana Festi, MD; Simonetta Friso, PhD; Luca Frulloni, MD; Paolo Gisondi, MD; Mauro Krampera, PhD; Giuseppe Lippi, PhD; Claudio Micheletto, MD; Giorgio Piacentini, PhD; Patrick Pinter, MD; Maurizio Rossini, PhD; Michele Schiappoli, MD; Cristina Tecchio, PhD; Laura Tenero, PhD; Elisa Tinazzi, PhD; Gianenrico Senna, MD; Matilde Carlucci, MD

World Allergy Organization Journal (Aug 2024)

Idiopathic hypereosinophilic syndromes and rare dysimmune conditions associated with hyper-eosinophilia in practice: An innovative multidisciplinary approach

Marco Caminati, MD,
Lucia Federica Carpagnano, MD,
Chiara Alberti, MSc,
Francesco Amaddeo, PhD,
Riccardo Bixio, MD,
Federico Caldart, MD,
Lucia De Franceschi, PhD,
Micol Del Giglio, PhD,
Giuliana Festi, MD,
Simonetta Friso, PhD,
Luca Frulloni, MD,
Paolo Gisondi, MD,
Mauro Krampera, PhD,
Giuseppe Lippi, PhD,
Claudio Micheletto, MD,
Giorgio Piacentini, PhD,
Patrick Pinter, MD,
Maurizio Rossini, PhD,
Michele Schiappoli, MD,
Cristina Tecchio, PhD,
Laura Tenero, PhD,
Elisa Tinazzi, PhD,
Gianenrico Senna, MD,
Matilde Carlucci, MD

Affiliations

Marco Caminati, MD: Department of Medicine, University of Verona, Verona, Italy; Allergy Unit and Asthma Center, Verona Integrated University Hospital, Verona, Italy; Corresponding author. Department of Medicine, University of Verona, Piazzale Scuro10, 37134 Verona, Italy.
Lucia Federica Carpagnano, MD: University of Verona, Verona Italy
Chiara Alberti, MSc: Pharmacy Unit, Verona Integrated University Hospital, Verona, Italy
Francesco Amaddeo, PhD: Unit of Psychosomatics and Medical Psychology, Verona Integrated University Hospital, and Department of Neurosciences, Biomedicine and Movement, University of Verona, Italy
Riccardo Bixio, MD: Rheumatology Unit, Verona Integrated University Hospital, Verona, Italy
Federico Caldart, MD: Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, Verona Integrated University Hospital, Verona, Italy
Lucia De Franceschi, PhD: Department of Medicine, University of Verona, Verona, Italy; Unit of Internal Medicine B, Verona Integrated University Hospital, Verona Italy
Micol Del Giglio, PhD: Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
Giuliana Festi, MD: Pulmonology Unit, Verona Integrated University Hospital, Verona Italy
Simonetta Friso, PhD: Department of Medicine, University of Verona, Verona, Italy; Unit of Internal Medicine B, Verona Integrated University Hospital, Verona Italy
Luca Frulloni, MD: Department of Medicine, University of Verona, Verona, Italy; Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, Verona Integrated University Hospital, Verona, Italy
Paolo Gisondi, MD: Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
Mauro Krampera, PhD: Department of Engineering for Innovation Medicine, Section of Innovation Biomedicine, Hematology Area, University of Verona, Verona, Italy
Giuseppe Lippi, PhD: Section of Clinical Biochemistry and School of Medicine, University of Verona, Verona, Italy
Claudio Micheletto, MD: Pulmonology Unit, Verona Integrated University Hospital, Verona Italy
Giorgio Piacentini, PhD: Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Clinic, University of Verona, Verona, Italy
Patrick Pinter, MD: Unit of Otolaryngology, Head and Neck Department, University of Verona, Verona, Italy
Maurizio Rossini, PhD: Department of Medicine, University of Verona, Verona, Italy; Rheumatology Unit, Verona Integrated University Hospital, Verona, Italy
Michele Schiappoli, MD: Allergy Unit and Asthma Center, Verona Integrated University Hospital, Verona, Italy
Cristina Tecchio, PhD: Department of Engineering for Innovation Medicine, Section of Innovation Biomedicine, Hematology Area, University of Verona, Verona, Italy
Laura Tenero, PhD: Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Clinic, University of Verona, Verona, Italy
Elisa Tinazzi, PhD: Unit of Internal Medicine B, Verona Integrated University Hospital, Verona Italy
Gianenrico Senna, MD: Department of Medicine, University of Verona, Verona, Italy; Allergy Unit and Asthma Center, Verona Integrated University Hospital, Verona, Italy
Matilde Carlucci, MD: Health Directorate, Verona Integrated University Hospital, Verona, Italy

Journal volume & issue: Vol. 17, no. 8
p. 100928

Abstract

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Hypereosinophilic syndromes (HES) represent a group of rare dis-immune conditions characterized by blood hyper-eosinophilia and eosinophilic related burden. Especially the idiopathic subtype (I-HES) is particularly difficult to diagnose because of its heterogeneous clinical presentation, the lack of specific findings on physical exam, lab tools, and imaging informative enough to unequivocally confirm the diagnosis and the overlap with other entities, including eosinophilic organ-diseases or systemic dis-immune conditions other than I-HES (from atopy to eosinophilic granulomatosis with polyangiitis [EGPA], the last often extremely difficult to distinguish from HES). Taken together, all the features mentioned above account for an extremely difficult early recognition HES and on-time referral to a specialized centre. The referral itself is challenging due to a not univocal specialist identification, because of the variability of physicians managing HES in different settings (including allergist/clinical immunologist, haematologist, internal medicine doctors, pulmonologist, rheumatologist). Furthermore, the approach in terms of personalized treatment identification and follow-up plan (timing, organ assessment), is poorly standardized. Further translational and clinical research is needed to address the mentioned unmet needs, but on practical grounds increasing the overall clinicians’ awareness on HES and implementing healthcare pathways for HES patients represent a roadmap that every clinician might try to realize in his specific setting.The present review aims at providing an overview about the current challenges and unmet needs in the practical approach to HES and rare hypereosinophilic allergo-immunological diseases, including a proposal for an innovative multidisciplinary organizational model.

Published in World Allergy Organization Journal

ISSN: 1939-4551 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Immunologic diseases. Allergy
Website: https://www.sciencedirect.com/journal/world-allergy-organization-journal

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