METHODS article
Front. Med.
Sec. Precision Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1544047
Optimizing Diagnostic and Management Pathways for Patients with Eosinophilia of Unknown Origin: A Multidisciplinary Protocol for Urgent and Non-Urgent Evaluation
Provisionally accepted
Silvia Sánchez-Ramón1*
Gloria Candelas Rodríguez2
Jesús Gimeno Hernández3María Luisa González Gutiérrez4Sissy Fiorella Medina Salazar5Manuel Méndez Bailón6Begoña Navas Elorza5
Ángel Nieto Sánchez6Teresa Robledo Echarren4Santiago Rueda Esteban7Marcos Oliver Fragiel Saavedra8María Dolores Zamora Barrios9Cristina Martínez Prada2
Celina Benavente Cuesta5Celia Pinedo Sierra10- 1Hospital Clínico San Carlos, Department of Clinical Immunology, Madrid, Spain
- 2Hospital Clínico San Carlos, Department of Rheumatology, Madrid, Asturias, Spain
- 3Hospital Clínico San Carlos, Department of ENT, Madrid, Spain
- 4Hospital Clínico San Carlos, Department of Allergy, Madrid, Spain
- 5Hospital Clínico San Carlos, Department of Hematology and Hemotherapy, Madrid, Spain
- 6Hospital Clínico San Carlos, Department of Internal Medicine, Madrid, Spain
- 7Hospital Clínico San Carlos, Department of Pediatrics, Madrid, Spain
- 8Hospital Clínico San Carlos, Department of Internal Medicine (Emergency Room), Madrid, Spain
- 9Hospital Clínico San Carlos, Department of Pharmacy, Madrid, Spain
- 10Hospital Clínico San Carlos, Department of Pulmonology, Madrid, Spain
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Introduction: Persistent eosinophilia of unknown cause is a key feature of numerous health disorders. These conditions present diagnostic and management challenges, often leading to delayed treatment, increased morbidity and mortality and unnecessary healthcare costs. A systematic approach to patient flow can streamline the process from presentation with eosinophilia to triage management, in hospital settings.Methods: A proposal of a novel patient flow pathway was developed through a collaborative effort involving 15 diverse multidisciplinary specialists in a public-funded tertiary teaching hospital located in Madrid, Spain, for managing eosinophilic diseases. This pathway focuses on early identification and expedited referral circuits in severe cases of hypereosinophilia and early screening of primary immunodeficient patients to optimize the journey from initial presentation through diagnosis and initial management. The proposed patient flow model is designed to be replicable in other hospital settings. Its implementation aims to facilitate timely diagnosis and reduce the preventable morbidity, mortality, suffering and economic burden associated with complex eosinophilic conditions.The development and implementation of a structured patient flow pathway for eosinophilia of unknown cause in a tertiary hospital setting demonstrates a significant step towards improving patient outcomes. This model serves as a template for other healthcare institutions seeking to enhance the management and care of patients with eosinophilic diseases.
Keywords: eosinophilia1, clinical protocol2, patient flow3, eosinophilic granulomatosis with polyangiitis4, chronic rhinosinusitis with nasal polyposis5, hypereosinophilic syndrome6, eosinophilic asthma7, primary immunodeficiencies8
Received: 20 Jan 2025; Accepted: 19 May 2025.
Copyright: © 2025 Sánchez-Ramón, Candelas Rodríguez, Gimeno Hernández, González Gutiérrez, Medina Salazar, Méndez Bailón, Navas Elorza, Nieto Sánchez, Robledo Echarren, Rueda Esteban, Fragiel Saavedra, Zamora Barrios, Martínez Prada, Benavente Cuesta and Pinedo Sierra. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Silvia Sánchez-Ramón, Hospital Clínico San Carlos, Department of Clinical Immunology, Madrid, Spain
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.