Brigden M, Graydon C
Medical Oncology Clinic, Penticton Regional Hospital, British Columbia, Canada.
Arch Pathol Lab Med. 1997 Sep;121(9):963-7.
To audit a cohort of ambulatory outpatients with eosinophilia detected on automated blood cell counting. Specific objectives included the determination of whether the eosinophilia had been anticipated, the etiology of the eosinophilia, the clinical follow-up and investigations performed on patients with eosinophilia, and the effect of the detection of eosinophilia on patient management and ultimate clinical outcome.
A year-long retrospective review of all patients with an absolute eosinophil count of greater than 0.7 x 10(9)/L.
A large outpatient laboratory system. The patient population was managed by family physicians and specialists.
Data collection included the results of the hematology profile, the absolute eosinophil count, the clinical situation responsible for the hematologic profile determination, and the probable cause of eosinophilia. Individual physicians were surveyed to determine if discovery of the eosinophilia had changed patient management plan or clinical outcome.
Out of 195,300 patients who had a hematology profile performed, 225 were found to have an absolute eosinophilia count higher than 0.7 x 10(9)/L. The overall incidence of eosinophilia in the study population was 0.1%. The eosinophilia was not anticipated in 85% of patients. No obvious cause was detected for the eosinophilia in 36% of patients. Various allergic diseases were responsible for the eosinophilia in the majority of the remaining patients. Fewer than 9% of individuals manifested a serious systemic illness or parasitemia. Further clinical follow-up had been performed in 69% of patients. Additional laboratory tests had been ordered in 59% of patients. The laboratory tests most frequently ordered were a repeat hematology profile or stool examinations for ova and parasites. In only two instances did the discovery of the eosinophilia appear to result in a significant change in patient management or ultimate clinical income.
The vast majority of eosinophilias detected in ambulatory outpatients are associated with allergic processes. An extensive investigation of eosinophilia in ambulatory North American outpatients does not appear to be warranted unless specifically indicated by the results of the history and physical examination.
对一批在自动血细胞计数中检测到嗜酸性粒细胞增多的门诊患者进行审核。具体目标包括确定嗜酸性粒细胞增多是否在预料之中、嗜酸性粒细胞增多的病因、对嗜酸性粒细胞增多患者进行的临床随访和检查，以及嗜酸性粒细胞增多的检测对患者管理和最终临床结局的影响。
对所有绝对嗜酸性粒细胞计数大于0.7×10⁹/L的患者进行为期一年的回顾性研究。
一个大型门诊实验室系统。患者群体由家庭医生和专科医生管理。
数据收集包括血液学检查结果、绝对嗜酸性粒细胞计数、决定血液学检查结果的临床情况以及嗜酸性粒细胞增多的可能原因。对个体医生进行调查，以确定嗜酸性粒细胞增多的发现是否改变了患者的管理计划或临床结局。
在195300名进行了血液学检查的患者中，发现225名患者的绝对嗜酸性粒细胞计数高于0.7×10⁹/L。研究人群中嗜酸性粒细胞增多的总体发生率为0.1%。85%的患者嗜酸性粒细胞增多未在预料之中。36%的患者未检测到嗜酸性粒细胞增多的明显原因。其余大多数患者的嗜酸性粒细胞增多由各种过敏性疾病引起。不到９%的个体表现出严重的全身性疾病或寄生虫血症。69%的患者进行了进一步的临床随访。59%的患者进行了额外的实验室检查。最常进行的实验室检查是重复血液学检查或粪便虫卵和寄生虫检查。仅在两例中，嗜酸性粒细胞增多的发现似乎导致了患者管理或最终临床结局的显著改变。
门诊患者中检测到的绝大多数嗜酸性粒细胞增多与过敏过程有关。除非病史和体格检查结果有明确指示，否则对北美门诊患者的嗜酸性粒细胞增多进行广泛调查似乎没有必要。
