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A new index for distinguishing hypereosinophilic syndrome and antineutrophil cytoplasmic antibody-negative eosinophilic granulomatosis with polyangiitis

Authors
 Sung Soo Ahn  ;  Juyoung Yoo  ;  Yong-Beom Park  ;  Jung-Won Park  ;  Jae-Hyun Lee  ;  Sang-Won Lee 
Citation
 ASIAN PACIFIC JOURNAL OF ALLERGY AND IMMUNOLOGY, Vol.41(3) : 244-252, 2023-09 
Journal Title
ASIAN PACIFIC JOURNAL OF ALLERGY AND IMMUNOLOGY
ISSN
 0125-877X 
Issue Date
2023-09
MeSH
Antibodies, Antineutrophil Cytoplasmic ; Churg-Strauss Syndrome* / diagnosis ; Eosinophils ; Granulomatosis with Polyangiitis* / diagnosis ; Humans ; Hypereosinophilic Syndrome* / diagnosis
Abstract
Background: It is difficult to differentiate between hypereosinophilic syndrome (HES) and antineutrophil cytoplasmic antibody (ANCA)-negative eosinophilic granulomatosis with polyangiitis (EGPA).

Objective: We compared laboratory data at diagnosis between Korean patients with HES and ANCA-negative EGPA and investigated independent laboratory predictors suggesting HES.

Methods: We reviewed the medical records of 41 HES patients and 16 ANCA-negative EGPA patients. The cut-offs were extrapolated by the receiver operator characteristic (ROC) curve. The odds ratio (OR) and relative risk (RR) were assessed using the multivariable logistic regression analysis and the chi-square test, respectively. We developed a new equation by assigning a weight to each variable according to the slopes (B) and expressed a decimal as the nearest integer.

Results: HES patients had a higher median WBC and eosinophil counts than ANCA-negative EGPA patients. The cutoffs of WBC and eosinophil counts for HES were set at 9,900.0/mm3 and 2,400.0/mm3. In the multivariable analysis, WBC count ≥ 9,900.0/mm3 (B 1.763) and eosinophil count ≥ 2,400.0/mm3 (B 1.515) were significantly associated with HES. An equation was as follows: HES-suggesting laboratory index (HSLI) = 2 × (WBC count ≥ 9,900.0/mm3 (1 = No or 2 = Yes)) + 1.5 × (eosinophil count ≥ 2,400.0/mm3 (1 = No or 2 = Yes)). The cut-off of HSLI for HES was 4.25. Patients with HSLI ≥ 4.25 exhibited a significantly high RR (51.429) for HES, compared to those without.

Conclusions: In conclusion, the cut-off of HSLI derived from WBC and eosinophil counts could be an independent predictor of HES in patients suspected of both HES and ANCA-negative EGPA.
Files in This Item:
T202305919.pdf Download
DOI
10.12932/ap-080420-0805
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Yong Beom(박용범)
Park, Jung Won(박중원) ORCID logo https://orcid.org/0000-0003-0249-8749
Ahn, Sung Soo(안성수) ORCID logo https://orcid.org/0000-0002-9002-9880
Yoo, Juyoung(유주영) ORCID logo https://orcid.org/0000-0001-8882-1695
Lee, Sang-Won(이상원) ORCID logo https://orcid.org/0000-0002-8038-3341
Lee, Jae Hyun(이재현) ORCID logo https://orcid.org/0000-0002-0760-0071
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/196566
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