What is the role of lab testing in the workup of eosinophilic fasciitis (EF)?

Updated: Dec 24, 2020
  • Author: Peter M Henning, DO; Chief Editor: Herbert S Diamond, MD  more...
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Characteristic laboratory findings of eosinophilic fasciitis (EF) include the following:

  • Peripheral blood eosinophilia is present in 61%-83% of patients. The degree of eosinophilia is variable over time, even in the absence of specific therapy. [14, 44, 45]

  • Hypergammaglobulinemia is characteristic, although this finding varies widely by case series, occurring in 18%-67% of patients. It is most often due to a polyclonal increase in immunoglobulin G. [33, 15, 44]

  • An increase in the erythrocyte sedimentation rate (ESR) is found in 29%-70% of cases. [33]

Additional laboratory findings of eosinophilic fasciitis include the following: [14, 15, 44]

  • Serum creatine kinase and aldolase levels are generally normal.

  • Rheumatoid factor (RF) and antinuclear antibodies are occasionally positive.

  • Hematologic abnormalities and disease are associated with eosinophilic fasciitis. Aplastic anemia, although rare, is the most frequent common associated hematological complication, but cases have been described with thrombocytopenia, hemolytic anemia, pernicious anemia, lymphoma, and leukemia. [34, 46]

  • Borrelia serology or polymerase chain reaction (PCR) findings are occasionally positive and may suggest a treatable etiology. However, as discussed above, the exact correlation between eosinophilic fasciitis and Borrelia remains unclear. [19, 20]

  • Metalloproteinase 1 (TIMP-1) may be a new serological marker of disease activity. [13]

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