Extreme Eosinophilia with Iodide Hypersensitivity

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Abstract
THE differentiation of leukemoid reactions from leukemia, although frequently difficult, can be especially so when involving eosinophilic granulocytes. In cases of extreme leukocytosis the presence of neutrophils with toxic granulation, Döhle bodies or vacuolation1 strongly suggests a non-neoplastic cause of the reaction. With eosinophilic granulocytes, however, these aids are lacking, therefore preventing morphologic differentiation of eosinophilic leukemia from a variety of hypersensitivity syndromes manifesting eosinophilia. In addition, neutrophilic leukemoid reactions associated with septic or necrotic processes are generally brief, permitting early retrospective diagnosis. In contrast, prolonged eosinophilia occurs with many chronic allergic syndromes, compounding further the difficulties in differential diagnosis. . . .