Value of eosinopenia in inflammatory disorders: an "old" marker revisited

Purpose. -The value of eosinopenia as a test in favour of an infectious disease was suggested by Schilling since 1929. We tried to verify this hypothesis with a prospective and multicentric study. Patients and methods. -One thousand and thirty-eight patients were included (82 females and 56 males, means age: 71.8 years). Diagnoses were: 83 infectious diseases, 38 systemic diseases, 10 neoplasia and 7 miscellaneous. Results. -The mean value of eosinophils was 72/mm(3) in bacterial infectious diseases and 214/mm(3) in non infectious diseases (P < 0.01). When leukocytes were higher than 10,000/mm(3) and eosinophils counts less than 40/mm(3), predictive value for an infectious bacterial disease was 100% as well as specificity. Under same conditions, when protein C reactive was higher than 100mg.l(-1), the predictive value was 85% and the specificity was 57%. Conclusion. -Our study shows that an inflammatory syndrome associated with hyperleucocytosis above 10,000/mm(3) and eosinophils counts under 40/mm(3) seems strongly related to bacterial infectious diseases. (C) 2003 Editions scientifiques et medicales Elsevier SAS. Tons droits reserves.