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January 1994

Hypereosinophilia Secondary to Immunodysregulation in Patients With HIV-1 Disease

Author Affiliations

USA Washington, DC

USN Department of Dermatopathology Armed Forces Institute of Pathology Washington, DC

USA Washington, DC

Rebecca Ledsky

Bethesda, Md

Arch Dermatol. 1994;130(1):119-121. doi:10.1001/archderm.1994.01690010125029

We have seen eight patients positive for human immunodeficiency virus type 1 (HIV-1) with marked peripheral eosinophilia, lasting 4 months or longer, in which no causal agent was identified. In addition, we have seen a progressive increase in peripheral eosinophilia and a similar increase in tissue eosinophilia in our patient population that is associated with increasing Walter Reed stage (Figure 1).1

Materials and Methods.  All patients with markedly elevated eosinophil levels (over 20% of the total white blood cell count) (Table) had regular complete blood cell counts obtained over a 30-month period. Urinalysis, liver and renal function tests, and multiple serologic tests for infectious organisms were administered for all patients. In some cases, tests for connective tissue disease, chest roentgenograms, electrocardiograms, multiple stool samples, bone marrow aspirates, and biopsy specimens were performed or obtained. A battery of special stains (periodic acid-Schiff, Gomori methenamine silver, Brown and Hoppes, Ziehl-Neelsen, and

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