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Abstract The causes of peripheral blood eosinophilia range from benign eosinophilia to hypereosinophilic syndrome (HES) and malignancies. Clinical evaluation with a careful history and physical examination may help to determine the underlying cause. HES is a diagnosis of exclusion. Although drug allergy and parasitic diseases are common known causes of hypereosinophilia, it can also be seen in allergic diseases andvarious immunodeficiencies. Treatment is based on underlying disease. HES should be considered in patients with moderate to severe eosinophilia because delayed diagnosis and treatment may result in organ damage