Bancroftian lymphadenopathy: absence of eosinophils in tissues despite peripheral blood hypereosinophilia.
We studied the association of eosinophils with Wuchereria bancrofti parasites in two children with biopsy-proven filarial lymphadenopathy and peripheral blood hypereosinophilia. In both cases, intact adult worms were present in lymph nodes but no inflammatory reaction was observed. The most remarkable histological feature in our patients was the absence of eosinophils in tissue sections in spite of persistently high numbers of eosinophils in peripheral blood. In the first case, treatment of intestinal parasites before lymph node excision promptly reduced eosinophil counts to normal levels even though levels of microfilaraemia remained virtually unchanged. In the second patient, hypereosinophilia persisted after lymph node resection but disappeared following curative treatment of intestinal helminths. These observations raise fundamental questions about the causal relationship and the role of eosinophils in lymphatic filariasis.
Figueredo-Silva
J
J
Laboratorio de Imunopatologia Keizo Asami, Universidade Federal de Pernambuco, Recife, PE, Brasil.
Dreyer
G
G
Guimarães
K
K
Brandt
C
C
Medeiros
Z
Z
D000293:Adolescent; D000818:Animals; D002648:Child; D004049:Diethylcarbamazine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004605:Elephantiasis, Filarial / Q000097:blood / Q000473:pathology* / Q000628:therapy; D004802:Eosinophilia / Q000097:blood / Q000473:pathology* / Q000628:therapy; D004804:Eosinophils; D005260:Female; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000097:blood / Q000473:pathology / Q000628:therapy; D007958:Leukocyte Count; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000469:parasitology / Q000473:pathology*; D008297:Male; D008463:Mebendazole / Q000627:therapeutic use; D013827:Thiabendazole / Q000627:therapeutic use; D014958:Wuchereria bancrofti
D008463:Mebendazole; D013827:Thiabendazole; D004049:Diethylcarbamazine