Abstract：
OBJECTIVE: Paediatric eosinophilia is a common clinical dilemma, often leading to resource- and time-consuming assessments. We aim to evaluate the main aetiologies of eosinophilia in children from different socioeconomic settings and propose a diagnostic algorithm.
METHODS: A systematic literature review was conducted through PubMed, Embase and the Cochrane Library. Studies published from January 2012 to June 2023 reporting the incidence and aetiology of peripheral eosinophilia in children were included. Evidence from studies on children originating from low- or high-income countries was compared.
RESULTS: A total of 15 observational studies, encompassing 3409 children, were included. The causes of eosinophilia varied based on the children\'s origin and the eosinophilia severity. In children from high-income countries, allergic diseases were the leading cause, with a prevalence of 7.7%-78.2%, while parasitosis ranged from 1.0% to 9.1%. In children from low-income countries, parasitosis was predominant, ranging from 17.7% to 88.3%, although allergic diseases were found in 2.5%-4.8% of cases. Concerning severity, allergic diseases were the leading cause of mild-to-moderate eosinophilia; parasitosis was associated with moderate-to-severe eosinophilia, while immunological disorders were mostly found in severe cases.
CONCLUSIONS: We developed a step-up diagnostic algorithm that considers the child\'s origin and eosinophilia severity and could optimise resource allocation.
METHODS: A systematic literature review was conducted through PubMed, Embase and the Cochrane Library. Studies published from January 2012 to June 2023 reporting the incidence and aetiology of peripheral eosinophilia in children were included. Evidence from studies on children originating from low- or high-income countries was compared.
RESULTS: A total of 15 observational studies, encompassing 3409 children, were included. The causes of eosinophilia varied based on the children\'s origin and the eosinophilia severity. In children from high-income countries, allergic diseases were the leading cause, with a prevalence of 7.7%-78.2%, while parasitosis ranged from 1.0% to 9.1%. In children from low-income countries, parasitosis was predominant, ranging from 17.7% to 88.3%, although allergic diseases were found in 2.5%-4.8% of cases. Concerning severity, allergic diseases were the leading cause of mild-to-moderate eosinophilia; parasitosis was associated with moderate-to-severe eosinophilia, while immunological disorders were mostly found in severe cases.
CONCLUSIONS: We developed a step-up diagnostic algorithm that considers the child\'s origin and eosinophilia severity and could optimise resource allocation.
摘要：
目的：儿童嗜酸性粒细胞增多是临床上常见的难题，通常导致资源和耗时的评估。我们旨在评估来自不同社会经济环境的儿童嗜酸性粒细胞增多的主要病因，并提出诊断算法。
方法：通过PubMed进行了系统的文献综述，Embase和Cochrane图书馆。纳入2012年1月至2023年6月发表的报告儿童外周嗜酸性粒细胞增多的发病率和病因的研究。比较了来自低收入或高收入国家儿童研究的证据。
结果：共15项观察性研究，包括3409名儿童，包括在内。嗜酸性粒细胞增多的原因因儿童的起源和嗜酸性粒细胞增多的严重程度而异。在高收入国家的儿童中，过敏性疾病是主要原因,患病率为7.7%-78.2%，而寄生虫病从1.0%到9.1%不等。在低收入国家的儿童中，寄生虫病占主导地位,从17.7%到88.3%，尽管在2.5％-4.8％的病例中发现了过敏性疾病。关于严重性，过敏性疾病是轻度至中度嗜酸性粒细胞增多的主要原因；寄生虫病与中度至重度嗜酸性粒细胞增多有关，而免疫疾病大多见于严重病例。
结论：我们开发了一种升级诊断算法，该算法考虑了儿童的起源和嗜酸性粒细胞增多的严重程度，并可以优化资源分配。
方法：通过PubMed进行了系统的文献综述，Embase和Cochrane图书馆。纳入2012年1月至2023年6月发表的报告儿童外周嗜酸性粒细胞增多的发病率和病因的研究。比较了来自低收入或高收入国家儿童研究的证据。
结果：共15项观察性研究，包括3409名儿童，包括在内。嗜酸性粒细胞增多的原因因儿童的起源和嗜酸性粒细胞增多的严重程度而异。在高收入国家的儿童中，过敏性疾病是主要原因,患病率为7.7%-78.2%，而寄生虫病从1.0%到9.1%不等。在低收入国家的儿童中，寄生虫病占主导地位,从17.7%到88.3%，尽管在2.5％-4.8％的病例中发现了过敏性疾病。关于严重性，过敏性疾病是轻度至中度嗜酸性粒细胞增多的主要原因；寄生虫病与中度至重度嗜酸性粒细胞增多有关，而免疫疾病大多见于严重病例。
结论：我们开发了一种升级诊断算法，该算法考虑了儿童的起源和嗜酸性粒细胞增多的严重程度，并可以优化资源分配。
