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Review
. 2010 Jul;126(1):45-9.
doi: 10.1016/j.jaci.2010.03.042.

Refining the definition of hypereosinophilic syndrome

Hans-Uwe Simon  1 , Marc E Rothenberg, Bruce S Bochner, Peter F Weller, Andrew J Wardlaw, Michael E Wechsler, Lanny J Rosenwasser, Florence Roufosse, Gerald J Gleich, Amy D Klion
Affiliations
Review

Refining the definition of hypereosinophilic syndrome

Hans-Uwe Simon et al. J Allergy Clin Immunol. 2010 Jul.

Abstract

Because of advances in our understanding of the hypereosinophilic syndrome (HES) and the availability of novel therapeutic agents, the original criteria defining these disorders are becoming increasingly problematic. Here, we discuss shortcomings with the current definition of HES and recent developments in the classification of these disorders. Despite significant progress in our understanding of the pathogenesis of some forms of HES, the current state of knowledge is still insufficient to formulate a new comprehensive etiologic definition of HESs. Nevertheless, we suggest a new working definition that overcomes some of the most obvious limitations with the original definition.

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Conflict of interest statement

Disclosure of potential conflict of interest: H.-U. Simon has received research support from GlaxoSmithKline, AstraZeneca, Roche, CSL Behring, and Nycomed, and has provided legal consultation or expert witness testimony for Pfizer on the topic of general pharmacology. M. E. Rothenberg has consulted for and given talks for Merck; has consulted for Centocor, Ception Therapeutics, Nycomed, Array BioPharma, Biocrystal Pharmaceuticals, and Endo Pharmaceuticals; has received research support from the National Institutes of Health, the Food Allergy and Anaphylaxis Network, and the Dana Foundation; is on the medical advisory board of the American Partnership for Eosinophilic Diseases; and is on the executive council of the International Eosinophil Society. B. S. Bochner has consulted for Sanofi-Aventis and GlaxoSmithKline and has received research support from Sanofi-Aventis. P. F. Weller has received research support from Merck and has provided legal consultation services or expert witness testimony on the topic of eosinophilic diseases. A. J. Wardlaw is on advisory boards for GlaxoSmithKline and has received research support from GlaxoSmithKline, Pfizer, and AstraZeneca. M. E. Wechsler has consulted for and given talks for Genentech, Merck, and Novartis; has consulted for MedImmune, Medicinova, and GlaxoSmithKline; is on the data safety monitoring board for MAP Pharmaceuticals; and has received research support from the National Institutes of Health and GlaxoSmithKline. L. J. Rosenwasser has received research support from Novartis and Genentech and has consulted for Alcon, Sanofi-Aventis, GlaxoSmithKline, and AstraZeneca. F. Roufosse has consulted for GlaxoSmithKline. G. J. Gleich has provided legal consultation or expert witness testimony on the topic of heparin contamination and is on the board of directors for the American Partnership for Eosinophilic Disorders. A. D. Klion declares that she has no relevant conflicts of interest to disclose.

Figures

FIG 1
FIG 1
Revised classification of HESs. Changes from the previous classification are indicated in red. Dashed arrows identify HES forms for which at least some patients have T cell–driven disease. Classification of myeloproliferative forms has been simplified, and patients with HES and eosinophil hematopoietin–producing T cells in the absence of a T-cell clone are included in the lymphocytic forms of HES. IBD, Inflammatory bowel disease.
See this image and copyright information in PMC

References

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