Tropical pulmonary eosinophilia among expatriate Indian workers in Saudi Arabia: a case series
Abstract Background Tropical pulmonary eosinophilia (TPE) is an uncommon but important manifestation of lymphatic filarial infection, caused primarily by Wuchereria bancrofti, Brugia malayi, and Brugia timori. This syndrome results from a hypersensitivity reaction to microfilariae. While lymphatic f...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2025-08-01
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| Series: | The Egyptian Journal of Bronchology |
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| Online Access: | https://doi.org/10.1186/s43168-025-00436-9 |
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| author | Salah A. M. Ali Hasanain A. J. Gharban Hala Alfaki Mona Ibrahim Ahmed Randa I. Ahmed |
| author_facet | Salah A. M. Ali Hasanain A. J. Gharban Hala Alfaki Mona Ibrahim Ahmed Randa I. Ahmed |
| author_sort | Salah A. M. Ali |
| collection | DOAJ |
| description | Abstract Background Tropical pulmonary eosinophilia (TPE) is an uncommon but important manifestation of lymphatic filarial infection, caused primarily by Wuchereria bancrofti, Brugia malayi, and Brugia timori. This syndrome results from a hypersensitivity reaction to microfilariae. While lymphatic filariasis is rare in Saudi Arabia, isolated cases have been observed among expatriate Asian workers. With increasing global migration, clinicians in non-endemic regions should consider TPE in patients with compatible clinical and exposure histories. Objectives This study aims to raise awareness among healthcare providers in Saudi Arabia regarding TPE as a treatable infectious disease among immigrants from endemic regions of India. It also seeks to recommend the incorporation of TPE considerations into asthma diagnosis guidelines for Indian patients from endemic areas, and to propose a diagnostic roadmap for the syndrome. Methods A retrospective chart review was conducted at the Chest Clinic of Al Mouwasat Hospital in Jubail, Eastern Province, Saudi Arabia. Medical records from January 2023 to January 2024 were examined for patients presenting with asthma-like symptoms and laboratory or radiological findings consistent with TPE. Only data from existing records were included; no prospective data collection was performed. Results Eight patients met all six diagnostic criteria for TPE: a relevant history of exposure, marked eosinophilia, elevated immunoglobulin E (IgE), positive filarial-specific antibodies, negative blood films for microfilariae, and a favorable response to diethylcarbamazine therapy. Two additional patients satisfied five of the six diagnostic criteria and also responded well to diethylcarbamazine. Conclusion TPE should be considered in the differential diagnosis for expatriates from endemic regions presenting with suggestive clinical and laboratory features in Saudi Arabia. Increasing clinical awareness and applying structured diagnostic protocols may improve detection and treatment outcomes for this rare but treatable disease. |
| format | Article |
| id | doaj-art-a7dffe4bde9c4491956ef705f743436c |
| institution | Kabale University |
| issn | 2314-8551 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Bronchology |
| spelling | doaj-art-a7dffe4bde9c4491956ef705f743436c2025-08-20T03:42:20ZengSpringerOpenThe Egyptian Journal of Bronchology2314-85512025-08-0119111310.1186/s43168-025-00436-9Tropical pulmonary eosinophilia among expatriate Indian workers in Saudi Arabia: a case seriesSalah A. M. Ali0Hasanain A. J. Gharban1Hala Alfaki2Mona Ibrahim Ahmed3Randa I. Ahmed4Department of Medicine, Mouwasat HospitalDepartment of Internal and Preventive Veterinary Medicine, College of Veterinary Medicine, University of WasitDepartment of Medicine, Mouwasat HospitalFayoum University HospitalFayoum UniversityAbstract Background Tropical pulmonary eosinophilia (TPE) is an uncommon but important manifestation of lymphatic filarial infection, caused primarily by Wuchereria bancrofti, Brugia malayi, and Brugia timori. This syndrome results from a hypersensitivity reaction to microfilariae. While lymphatic filariasis is rare in Saudi Arabia, isolated cases have been observed among expatriate Asian workers. With increasing global migration, clinicians in non-endemic regions should consider TPE in patients with compatible clinical and exposure histories. Objectives This study aims to raise awareness among healthcare providers in Saudi Arabia regarding TPE as a treatable infectious disease among immigrants from endemic regions of India. It also seeks to recommend the incorporation of TPE considerations into asthma diagnosis guidelines for Indian patients from endemic areas, and to propose a diagnostic roadmap for the syndrome. Methods A retrospective chart review was conducted at the Chest Clinic of Al Mouwasat Hospital in Jubail, Eastern Province, Saudi Arabia. Medical records from January 2023 to January 2024 were examined for patients presenting with asthma-like symptoms and laboratory or radiological findings consistent with TPE. Only data from existing records were included; no prospective data collection was performed. Results Eight patients met all six diagnostic criteria for TPE: a relevant history of exposure, marked eosinophilia, elevated immunoglobulin E (IgE), positive filarial-specific antibodies, negative blood films for microfilariae, and a favorable response to diethylcarbamazine therapy. Two additional patients satisfied five of the six diagnostic criteria and also responded well to diethylcarbamazine. Conclusion TPE should be considered in the differential diagnosis for expatriates from endemic regions presenting with suggestive clinical and laboratory features in Saudi Arabia. Increasing clinical awareness and applying structured diagnostic protocols may improve detection and treatment outcomes for this rare but treatable disease.https://doi.org/10.1186/s43168-025-00436-9EosinophiliaDiethylcarbamazineFilariasisIgETropical pulmonary eosinophiliaPulmonary infiltrate |
| spellingShingle | Salah A. M. Ali Hasanain A. J. Gharban Hala Alfaki Mona Ibrahim Ahmed Randa I. Ahmed Tropical pulmonary eosinophilia among expatriate Indian workers in Saudi Arabia: a case series The Egyptian Journal of Bronchology Eosinophilia Diethylcarbamazine Filariasis IgE Tropical pulmonary eosinophilia Pulmonary infiltrate |
| title | Tropical pulmonary eosinophilia among expatriate Indian workers in Saudi Arabia: a case series |
| title_full | Tropical pulmonary eosinophilia among expatriate Indian workers in Saudi Arabia: a case series |
| title_fullStr | Tropical pulmonary eosinophilia among expatriate Indian workers in Saudi Arabia: a case series |
| title_full_unstemmed | Tropical pulmonary eosinophilia among expatriate Indian workers in Saudi Arabia: a case series |
| title_short | Tropical pulmonary eosinophilia among expatriate Indian workers in Saudi Arabia: a case series |
| title_sort | tropical pulmonary eosinophilia among expatriate indian workers in saudi arabia a case series |
| topic | Eosinophilia Diethylcarbamazine Filariasis IgE Tropical pulmonary eosinophilia Pulmonary infiltrate |
| url | https://doi.org/10.1186/s43168-025-00436-9 |
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