Eosinophilic diseases: classification, clinical and pathogenetic relationships, and an algorithmic approach to diagnosis

Frolova N.F., Volgina G.V., Fomina D.S., Kruglova T.S., Usatyuk S.S., Iskhakov R.T., Mutovina Z.Yu.

1) Moscow Clinical Research Center, Hospital No. 52, Moscow, Russia; 2) Russian University of Medicine, Moscow, Russia; 3) Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; 4) Central State Medical Academy of the Administrative Directorate of the President of the Russian Federation, Moscow, Russia

This literature review focuses on current understanding of eosinophil-associated diseases – a heterogeneous group of conditions united by a common feature: an increased number of eosinophils in the blood and/or tissues. This article systematizes current information on the classification, pathogenesis, and diagnosis of eosinophilia, hypereosinophilia (HE), and hypereosinophilic syndrome (HES). It is emphasized that an increased eosinophil count per se is not a diagnosis, but rather a symptom that can be primary (clonal), secondary (reactive), or idiopathic. The clinical manifestations of HE are polymorphic and can affect various organs, necessitating a multidisciplinary approach. The diagnostic algorithm discussed in this review is based on the sequential exclusion of conditions that are common causes of secondary HES, the search for clonality (hematological neoplasms), and a mandatory comprehensive assessment of target organ damage. Accurately determining the type of HES in accordance with current consensus classifications (WHO, ICOG-EO) is the cornerstone for selecting a personalized therapeutic strategy and determining the prognosis.

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About the Authors

Nadiya F. Frolova – Dr.Sci. (Med.), Deputy Chief Physician for Nephrology Care, Head of the Interdistrict Nephrology Center, Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department. Address: 3 Pekhotnaya St., Moscow, 123182. Associate Professor, Department of Nephrology, Faculty of Continuous Professional Education, Russian University of Medicine. Address: Bldg. 4, 1A Kuskovskaya St., Moscow, 111398, Email: nadiya.frolova@yandex.ru. ORCID: 0000-0002-6086-5220
Galina V. Volgina – Dr.Sci. (Med.), Professor, Department of Nephrology, Faculty of Continuous Professional Education, Russian University of Medicine. Address: Bldg. 4, 1A Kuskovskaya St., Moscow, 111398. Email: volginagv@mail.ru. ORCID: 0000-0002-7771-4074
Sergey S. Usatyuk – Head of Nephrology Department No. 2. Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department. Address: 3 Pekhotnaya St., Moscow, 123182. E-mail: usatuk-doc@mail.ru. ORCID: 0000-0002-8742-3860
Zinaida Yu. Mutovina – Cand.Sci. (Med.), Deputy Chief Physician for Medical Affairs, Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department. Address: 3 Pekhotnaya St., Moscow, 123182; Associate Professor at the Department of Therapy, Cardiology, and Functional Diagnostics with a Course in Nephrology, Central State Medical Academy of the Administrative Directorate of the President of the Russian Federation. Address: Bldg.1A, 19 Marshal Timoshenko St., Moscow, 121359. E-mail: zmutovina@mail.ru. ORCID: 0000-0001-5809-6015
Tatyana S.Kruglova – Head of the Allergology and Immunology Department, Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department. Address: 3 Pekhotnaya St., Moscow, 123182. E-mail: surckova.t@yandex.ru. ORCID: 0000-0002-4949-9178
Daria S. Fomina – Dr.Sci. (Med.), Professor, Deputy Director for Research and Clinical Work, Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department. Address: 3 Pekhotnaya St., Moscow, 123182; Chief External Expert in Allergology and Immunology of the Moscow Healthcare Department; Professor, Department of Clinical Immunology and Allergology, Sechenov First Moscow State Medical University (Sechenov University). Address: Bldg. 2, 8 Trubetskaya St., Moscow, 119048. E-mail: daria_fomina@mail.ru ORCID: 0000-0002-5083-6637
Rustam T. Iskhakov – Head of the Intensive Care Department for Nephrological Patients, Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department. Address: 3 Pekhotnaya St., Moscow, 123182. E-mail: stamius@yandex.ru. ORCID: 0000-0003-2850-4465

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