Symptoms of Hypereosinophilic Syndrome

The disease is more commonly seen in male patients aged 20-50 years; the children may be affected as well.

In approximately 75% of cases, the underlying cause is still unknown. In other cases, the following could be the causes:

• Myeloproliferative disorders: These are slow growing cancers that affect the red cells, white cells, and platelets in the bone marrow. Hypereosinophilic syndrome is often a part of these disorders.
• Genetic conditions: FIP1L1/PDGFRA gene mutation is seen in about 20% of patients of HES. This causes a particularly aggressive disease course.
• Increased production of a substance called interleukin-5 produced by white blood cells is implicated in a form of HES called lymphocytic HES.
• Sometimes, the HES runs in the family. This is due to a change (mutation) in an unknown gene passed down through a family. This form is called familial HES. If one parent has the disease, there is a 50% chance that the child will be having it.
• Some cases have new mutations in the gene. These people have no history of hypereosinophilia syndrome in their families.

Stem cell transplant offers a potential cure for HES; however, it clearly needs more research, and currently, it is not without its own significant risks and limitations.

At present, hypereosinophilic syndrome is manageable (but not curable) with proper drugs and chemotherapy.

HES is fatal if not treated, hence early intervention and proper medication must be sought. The outcome of the treatment and organ involvement differ from person to person. You must discuss the treatment protocol with your doctor for the best guidance over this.

FIP1L1/PDGFRA mutation must be treated aggressively. Imitinib mesylate (Gleevac) is the drug of choice here, which has an excellent response rate in almost all patients.

In the patients without FIP1L1/PDGFRA mutation, the Glucocorticoids (a type of steroid medication) are used as the drug of choice. If there is no response to these, then drugs like Vincristine, Hydroxyurea, or Cyclophosphamide may be used.

In cases of increased IL-5 subtypes of HES, Mepolizumab, Alemtuzumab, and Reslizumab medications show promising results.

Regular follow up tests for the liver and kidney function, serum, Vitamin B12 levels, erythrocyte sedimentation rate (ESR), and serum tryptase levels is a must in all patients. Even in the patients treated for the disease in the past, regular follow up with the doctor for blood tests is required to watch out for recurrence.