Eosinophilia and IgE Elevation: An Uncommon Toxocara Infection

Eosinophilia and elevated immunoglobulin E (IgE) levels are common indicators of parasitic infections, allergic reactions, or autoimmune conditions. In this clinical report, we present the case of a 56-year-old woman who was observed in a follow-up consultation, whose laboratory investigations revealed significant eosinophilia (5.52 × 10E³/uL) and elevated serum IgE levels (19253.00 IKU/L). The patient had no symptoms and the physical examination was unremarkable. An abdominal ultrasound was performed showing no abnormalities. Further diagnostic workup, including serological tests and imaging, led to the identification of Toxocariasis, a parasitic infection caused by the roundworm larvae of Toxocara canis, a parasitic nematode commonly transmitted via contaminated soil with animal feces. Upon further investigation, the patient was found to be diagnosed with Pica disorder which is characterized by the persistent craving and consumption of non-food substances, such as dirt, clay, chalk, paper, hair, or paint. After initiating antiparasitic treatment with albendazole, the patient showed a gradual normalization of eosinophil counts and IgE levels. This case highlights the importance of considering toxocariasis infection in patients presenting with eosinophilia and elevated IgE, even in an urban setting and areas of low prevalence of Toxocara such as Europe. In this case, the patient had no symptoms and four months prior laboratory work was without abnormalities. Early diagnosis and treatment are crucial for favorable outcomes.