In addition, some patients with IgG4-related disease can present with massive HE (> 3.0 × 109/L), which may sometimes be symptomatic (cases of eosinophilic cellulitis, thrombosis and eosinophilic pneumonia documented by BAL have been reported) and refractory to treatment targeting the IL-5 pathway, hence with potential diagnostic delay [57]. Here, IL5 is linked to hereditary elliptocytosis.