[2] This condition is more widely recognised and promptly diagnosed in filariasis-endemic regions, such as the Indian subcontinent, Africa, Asia and South America.

The clearance of rapidly opsonised microfilariae from the bloodstream results in a hypersensitive immunological process and abnormal recruitment of eosinophils, as reflected by extremely high IgE levels of over 1000 kU/L.

[7] A persistent or recurrent cough that is aggravated at night, along with fatigue, weight loss and a low-grade fever in an individual who has lived or traveled in an area where filariasis is endemic suggests the diagnosis of this disease.

Other parasitic infections, such as the zoonotic filariae, dirofilariasis, ascariasis, strongyloidiasis, visceral larva migrans and hookworm disease, may also be confused with TPE because of overlapping clinical features, serological profile and response to diethylcarbamazine.

[3] The antifilarial diethylcarbamazine (6 mg/kg/day in three divided doses[2] for 21 days[8] remains the main therapeutic agent, and is generally well tolerated.