Case 150 – update 1

You advise the GP to refer to the haematology clinic in view of her eosinophilia and unexplained weight loss.

When you see her clinic after about 4 weeks, she looks unwell. She tells you she has lost about 3kg in weight since she saw her GP. She is now experiencing significant diarrhoea and has developed a red itchy rash on her chest and thighs. She feels short of breath on exertion and extremely fatigued.

Her FBC is now:

Hb 91 g/L
Plt 168 x10^9/L
WCC 12.3 x10^9/L
Neutrophils 1.2 x10^9/L
Lymphocytes 2.1 x10^9/L
Monocytes 0.4 x10^9/L
Eosinophils 8.6 x10^9/L
Basophils 0.01 x10^9/L

Her blood film shows marked eosinophilia but is otherwise unremarkable.

How would you proceed at this point?

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