{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T22:39:47Z","timestamp":1769899187670,"version":"3.49.0"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Pediatric hypereosinophilia (HE) is rare, and its evaluation is challenging due to diverse etiologies and limited access to advanced laboratory testing in low\u2010 and middle\u2010income countries (LMICs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed five children with HE (absolute eosinophil count &gt;\u20095.0\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L) evaluated at a tertiary center. Clinical, hematologic, and molecular findings were reviewed, and diagnostic timelines were compared between clonal and non\u2010clonal cases. Based on these observations, a tiered, laboratory\u2010driven diagnostic pathway adapted for LMICs was developed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five patients (median age: 6\u2009years; range: 1.5\u201310\u2009years) were included. The median absolute eosinophil count (AEC) at presentation was 12.8\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L (range: 6.5\u201321.5\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L). Three cases (60%) were clonal eosinophilia\u2014one PDGFRB\u2010rearranged myeloid\/lymphoid neoplasm and two acute myeloid leukemia subtypes [AML with CBFB::MYH11, AML with RUNX1::RUNX1T1]\u2014and two cases (40%) were non\u2010clonal [one Hyper\u2010IgE syndrome with secondary hemophagocytic lymphohistiocytosis (HLH), one secondary eosinophilia (drug\u2010induced, phenytoin\/phenobarbitone)]. Clonal cases demonstrated higher leukocyte counts, earlier bone marrow and molecular testing, and shorter median time to diagnosis (6 vs. 14\u2009days), enabling prompt initiation of imatinib or AML\u2010directed therapy with remission in all. In contrast, non\u2010clonal HE required sequential exclusion of clonal disease, delaying immunosuppressive or drug\u2010withdrawal strategies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A structured, laboratory\u2010driven algorithm beginning with blood counts, smear, and parasitic testing, and escalating to early bone marrow with cytogenetic\/molecular studies for high\u2010risk phenotypes, enabled timely identification of clonal HE while conserving resources in reactive cases. This LMIC\u2010adapted pathway highlights laboratory turnaround time as a critical determinant of outcomes and provides a practical framework for pediatric HE evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijlh.70013","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T19:32:26Z","timestamp":1760556746000},"page":"150-164","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pediatric Severe Eosinophilia: Etiological Spectrum, Diagnostic Algorithm, and Case\u2010Based Insights From a Tertiary Care Center"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9575-0805","authenticated-orcid":false,"given":"Neha","family":"Goel","sequence":"first","affiliation":[{"name":"Division of Pediatric Hematology and Oncology, Department of Pediatrics Vardhman Mahavir Medical College and Safdarjung Hospital  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0024-8773","authenticated-orcid":false,"given":"Sumit","family":"Mehndiratta","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology and Oncology, Department of Pediatrics Vardhman Mahavir Medical College and Safdarjung Hospital  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satyendra","family":"Batra","sequence":"additional","affiliation":[{"name":"Department of Paediatric Oncology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4440-5339","authenticated-orcid":false,"given":"Amitabh","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology and Oncology, Department of Pediatrics Vardhaman Mahavir Medical College and Safdarjung Hospital  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4707-6374","authenticated-orcid":false,"given":"Prashant","family":"Prabhakar","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology and Oncology, Department of Pediatrics Vardhaman Mahavir Medical College and Safdarjung Hospital  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2884-3600","authenticated-orcid":false,"given":"Aroonima","family":"Misra","sequence":"additional","affiliation":[{"name":"Department of Health Research ICMR \u2013 National Institute of Child Health and Development Research  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5367-6050","authenticated-orcid":false,"given":"Bhavika","family":"Rishi","sequence":"additional","affiliation":[{"name":"Department of Health Research ICMR \u2013 National Institute of Child Health and Development Research  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2499-7779","authenticated-orcid":false,"given":"Nidhi","family":"Chopra","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology and Oncology, Department of Pediatrics Vardhaman Mahavir Medical College and Safdarjung Hospital  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8247-9283","authenticated-orcid":false,"given":"Sanghamitra","family":"Ray","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology and Oncology, Department of Pediatrics Vardhaman Mahavir Medical College and Safdarjung Hospital  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,15]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26352"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000489341"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2012.02.019"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13601\u2010019\u20100277\u20104"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2016.03.020"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.28757"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12288\u2010017\u20100829\u20105"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2018.01944"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2006.06038.x"},{"key":"e_1_2_12_11_1","volume-title":"Blood Cells: A Practical Guide","author":"Bain B. 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