COMMENTARY

Are Various Babesia Species a Missed Cause for Hypereosinophilia? A Follow-up on the First Reported Case of Imatinib Mesylate for Idiopathic Hypereosinophilia

James L. Schaller, MD, MAR; Glenn A. Burkland, DMD; PJ Langhoff

Disclosures

February 27, 2007

Conclusion

The patient, the patient's physicians, and his family feel that Babesia is a possible cause for both his HES and other ongoing problems that have significantly remitted. We simply agree that it should be included in the differential diagnosis of HES before a diagnosis of HES is given; it is not on a list that is quite full and useful.[35] This emerging protozoa parasite should be considered in any idiopathic HES case because parasitic infections can cause hypereosinophilia. Yet many other causes of hypereosinophilia exist, eg, genetic abnormalities, atopy, hypersensitivity reactions, collagen vascular diseases, and tumors.

We have shown that our HES patient has not relapsed over 5 years after ending a successful trial of imatinib. Empirical treatment for babesiosis produced significant improvements in long-standing morbidity. Therefore, these specific emerging protozoa, Babesia, should be considered in HES patients, especially those with possibly common symptoms such as increased fatigue, fevers, chills, or sweats.[36,37]

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