Easing the Burden of Hypereosinophilic Syndrome: An Animated Exploration of the Role of Targeted Therapy to Improve Patient Outcomes

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PVI, PeerView Institute for Medical Education

Chair, Paneez Khoury, MD, MHSc, FAAAAI, prepared useful Practice Aids pertaining to hypereosinophilic syndrome for this CME activity titled “Easing the Burden of Hypereosinophilic Syndrome: An Animated Exploration of the Role of Targeted Therapy to Improve Patient Outcomes.” For the full presentation, downloadable Practice Aids, and complete CME information, and to apply for credit, please visit us at https://bit.ly/3zKA94E. CME credit will be available until February 8, 2023.

Health & Medicine

Hypereosinophilic Syndrome: Recommended Evaluation According
to End-Organ Complications and/or Laboratory Abnormalities1
Full abbreviations, accreditation, and disclosure information available at PeerView.com/DMP40
1. Curtis C, Ogbogu P. Clin Rev Allergy Immunol. 2016;50:240-251.
General Evaluation
• CBC with differential
• Peripheral smear
• Flow cytometry
• Serum tryptase
• Stool ova and parasites
• ANCA
• Serum B12 level
• HIV serologies
• Serum IgE
• Strongyloides IgG
• ESR/CRP
• ANA
Screening for
End-Organ Involvement
Cardiac
• Serum troponin
• ECG
• Echocardiogram
Gastrointestinal
• Liver enzymes
Pulmonary
• Pulmonary function tests
• Chest X-ray
Renal
• Blood urea
nitrogen/creatinine
• Urinalysis
Thorough History for Symptoms
Prominent
end-organ
symptoms or
lab/imaging
abnormalities?
Cardiac
• Cardiac MRI
• Endomyocardial biopsy
Hematologic
• Bone marrow biopsy
• Chest/abdomen/pelvis CT
• Peripheral FISH/RT-PCR
for FIP1L1-PDGFRA
• Cytogenetics
• Molecular testing for
other myeloid neoplasm
• Next-generation
sequencing as appropriate
Gastrointestinal
• Endoscopy or colonoscopy
with biopsies
• Abdominal CT scan
• Amylase/lipase
Dermatologic
• Skin biopsy
Otolaryngology
• Sinus
Renal
• Kidney biopsy
Neurologic
• Brain MRI or head CT
with contrast
• Electroencephalogram
• Nerve conduction studies
Pulmonary
• Bronchoalveolar lavage
• Lung biopsy
• Chest CT
Vascular
• Angiography or MRAs

Hypereosinophilic Syndrome:
Treatment by Subtype
Full abbreviations, accreditation, and disclosure information available at PeerView.com/DMP40
• Prompt treatment with glucocorticoids is
recommended for those with life-threatening
symptoms
• Treatments should be individualized by
HES classification
• Consider biologic or small-molecule therapy
for candidate patients to reduce flares
Lymphoid HES
• Glucocorticoids
• Immunosuppressives
• Interferon-α
• Biologic therapy
• JAK-STAT inhibitors
Idiopathic HES
• Glucocorticoids
• Interferon-α
• Hydroxyurea
• Biologic therapy
• Immunosuppressives
Overlap HES
• Glucocorticoids
• Dietary therapy
• Mepolizumab
• Immunosuppressives
Myeloid HES
• Glucocorticoids (limited benefit)
• Imatinib
• Second-generation TKIs
• JAK-STAT inhibitors

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