Total absence of eosinophils in a patient with chronic urticaria and vitiligo

A 71-year-old woman with chronic urticaria and vitiligo is reported who lacked eosinophil and basophil leukocytes in her blood, bone-marrow and skin. No IgE was detectable in serum. She had a low level of serum eosinophil cationic protein (ECP) which could indicate that some eosinophils had been formed but rapidly destroyed. There was, however, no ECP release when the patient's serum was mixed with heterologous eosinophils. Staining for eosinophilic proteins in white blood cells by monoclonal antibodies revealed no storage or secreted forms of ECP. The source of ECP in our patient therefore remains unknown.