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Eosinophilia and Kidney Disease: More than Just an Incidental Finding?

1
Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, 6020 Innsbruck, Austria
2
Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Korea
3
Department of Pediatric Nephrology, Severance Children’s Hospital, Seoul 03722, Korea
4
Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul 03722, Korea
5
Division of Cardiology, Emory University School of Medicine, Atlanta, GA 30322, USA
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2018, 7(12), 529; https://doi.org/10.3390/jcm7120529
Received: 12 November 2018 / Revised: 29 November 2018 / Accepted: 5 December 2018 / Published: 8 December 2018
(This article belongs to the Section Nephrology & Urology)
Peripheral blood eosinophilia (PBE), defined as 500 eosinophils or above per microliter (µL) blood, is a condition that is not uncommon but often neglected in the management of patients with chronic kidney disease (CKD), acute kidney injury (AKI), or patients on renal replacement therapy (RRT). The nature of PBE in the context of kidney diseases is predominantly secondary or reactive and has to be distinguished from primary eosinophilic disorders. Nonetheless, the finding of persistent PBE can be a useful clue for the differential diagnosis of underdiagnosed entities and overlapping syndromes, such as eosinophilic granulomatosis with polyangiitis (EGPA), IgG4-related disease (IgG4-RD), acute interstitial nephritis (AIN), or the hypereosinophilic syndrome (HES). For patients on RRT, PBE may be an indicator for bio-incompatibility of the dialysis material, acute allograft rejection, or Strongyloides hyperinfection. In a subset of patients with EGPA, eosinophils might even be the driving force in disease pathogenesis. This improved understanding is already being used to facilitate novel therapeutic options. Mepolizumab has been licensed for the management of EGPA and is applied with the aim to abrogate the underlying immunologic process by blocking interleukin-5. The current article provides an overview of different renal pathologies that are associated with PBE. Further scientific effort is required to understand the exact role and function of eosinophils in these disorders which may pave the way to improved interdisciplinary management of such patients. View Full-Text
Keywords: eosinophilia; CKD; kidney disease; AKI; autoimmune disease; EGPA; interstitial nephritis; IgG4-related disease; vasculitis eosinophilia; CKD; kidney disease; AKI; autoimmune disease; EGPA; interstitial nephritis; IgG4-related disease; vasculitis
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MDPI and ACS Style

Gauckler, P.; Shin, J.I.; Mayer, G.; Kronbichler, A. Eosinophilia and Kidney Disease: More than Just an Incidental Finding? J. Clin. Med. 2018, 7, 529. https://doi.org/10.3390/jcm7120529

AMA Style

Gauckler P, Shin JI, Mayer G, Kronbichler A. Eosinophilia and Kidney Disease: More than Just an Incidental Finding? Journal of Clinical Medicine. 2018; 7(12):529. https://doi.org/10.3390/jcm7120529

Chicago/Turabian Style

Gauckler, Philipp; Shin, Jae I.; Mayer, Gert; Kronbichler, Andreas. 2018. "Eosinophilia and Kidney Disease: More than Just an Incidental Finding?" J. Clin. Med. 7, no. 12: 529. https://doi.org/10.3390/jcm7120529

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