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May 2005

Angioedema, Eosinophilia, and Fever—Diagnosis

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Copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2005

Arch Dermatol. 2005;141(5):633-638. doi:10.1001/archderm.141.5.633-f

Histopathologic examination of the skin biopsy specimen showed a dense diffuse eosinophilic infiltrate in the upper reticular dermis, without signs of vasculitis or flame figures. A cervical lymph node revealed an eosinophilic infiltrate. Ophthalmologic and otorhinolaryngologic examinations showed edematous lacrimal glands and nasal mucosa, which, on microscopic examination, revealed numerous infiltrating eosinophils. Ultrasonography and computed tomographic scans showed multiple enlarged cervical, axillary, inguinal, and retroperitoneal lymph nodes. There was no evidence of cardiac or other visceral organ involvement. Laboratory tests revealed marked eosinophilia (eosinophils, 21.0×103/μL [70%]; reference value, <0.6×103/μL [reference range, 0%-6%]), hypoalbuminemia, increased erythrocyte sedimentation rate, and elevated levels of serum IgM, IgE, C-reactive protein, and eosinophil cationic protein. A bone marrow examination showed increased numbers of eosinophil precursors but no signs of malignancy.

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