Loefflers syndrome laboratory findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]

A complete blood count (CBC) with differential may show increased white blood cells, particularly eosinophils. In Loeffler syndrome eosinophilia is generally mild to moderate, usually 5-20%. On the other hand, in certain types of pulmonary eosinophilia, higher percentages are reported. For example, in drug-induced eosinophilia, eosinophils may account for as much as 40% of the WBCs. Generally, the result of stool examination is negative at the time of the Loeffler syndrome presentation. Nevertheless, parasites and ova can be found in the stool 6-12 weeks after the initial parasitic infection. Pulmonary symptoms usually have been resolved when parasitic forms are found in the stool. Immunoglobulin E (IgE) level might be elevated. A bronchoscopy with bronchoalveolar lavage may show increased eosinophilic count. Sputum analysis or gastric lavage may occasionally show larvae of Ascaris or the other parasites with pulmonary cycle.

Laboratory findings consistent with the diagnosis of Loeffler syndrome include:^{[1][2][1][3] [4][5][6][7][8]}

• CBC diff

• A complete blood count (CBC) with differential may show increased white blood cells, particularly eosinophils.
• In Loeffler syndrome eosinophilia is generally mild to moderate, usually 5-20%.
• On the other hand, in certain types of pulmonary eosinophilia, higher percentages are reported.
• For example, in drug-induced eosinophilia, eosinophils may account for as much as 40% of the WBCs.

• Stool exam

• Generally the result of stool examination is negative at the time of the Loeffler syndrome presentation.
• Nevertheless, parasites and ova can be found in the stool 6-12 weeks after the initial parasitic infection.
• Pulmonary symptoms usually have been resolved when parasitic forms are found in the stool.

• Immunoglobulin E (IgE) level

• Might be elevated.

• Bronchoscopy and bronchoalveolar lavage

• A bronchoscopy with bronchoalveolar lavage may show increased eosinophilic count.

• Sputum analysis or gastric lavage

• Sputum analysis or gastric lavage may occasionally show Larvae of Ascaris or the other parasites with pulmonary cycle.

• 4-6 weeks after the initial presentation: Repeat CBC count (document resolution of eosinophilia).
• 6-12 weeks after initial presentation: Examine stool for ova and parasites.

Template:WH Template:WS