Abstract
Eosinophilia or a rise in the eosinophil count can occur due to allergy or skin infection, or due to HIV infection or cancer. Read the article to know more.
Published on Jul 10, 2018 and last reviewed on Aug 11, 2022 - 2 min read
Abstract
Eosinophilia or a rise in the eosinophil count can occur due to allergy or skin infection, or due to HIV infection or cancer. Read the article to know more.
Eosinophilia is said to be present when the absolute eosinophil count is more than 400/cmm (some books mention eosinophilia when the absolute count is more than 500/cmm).
Etiology: I will describe in brief the causes of eosinophilia so that it will help in detecting the underlying cause of eosinophilia.
1. Allergic disorders: This is the first cause that has to be ruled out.
2. Parasitic infestations: Following parasites can lead to high eosinophils.
3. Skin disease:
4. Pulmonary eosinophilia
5. Miscellaneous:
So, according to need various tests are done.
- In allergy disorder, Corticosteroid or Montelukast or strong anti-inflammatory drug can be prescribed.
- In asthma, bronchodilator inhaler or nebulization also can be prescribed as per need.
- For parasites, Albendazole 400 mg is a good drug.
- For skin problem, according to the cause, treatment is done like for example, topical Betamethasone.
Footnote: Do not neglect high eosinophils in CBC. Rule out the underlying cause and accordingly, treatment is done. Hope this article is useful to you.
For more information consult an allergy management specialist online --> https://www.icliniq.com/ask-a-doctor-online/allergy-specialist/allergy-management
A normal healthy adult has fewer than 500 cells per microliter of blood. Counts higher than 500 and 1500 cells per microliter indicate eosinophilia and hypereosinophilia, respectively.
Parasitic worm infection, autoimmune disorders, allergic reactions, seasonal allergies, eczema, cancer, ulcerative colitis, Crohn’s disease, drug reaction, asthma, scarlet fever, lupus, organ transplant rejection, adrenal gland deficiency, and fungal infections are some conditions where the eosinophil count is raised.
Eosinophilia can be due to less serious, serious, and potentially life-threatening causes. Hence detection of the cause for eosinophilia is essential for its treatment. Blood cancer, other cancers, DRESS (drug reaction with eosinophilia and systemic symptoms), and acute hypereosinophilic syndrome are severe life-threatening conditions.
Eosinophilia is curable upon the correction of the underlying less serious cause. In case of a drug reaction, the drug should be stopped. Antiparasitic medications, steroids, eliminating potential allergens, etc., are cause-specific treatment methodologies. In primary eosinophilia, where there is increased eosinophils due to mutation, corticosteroids are used.
Allergic reactions, autoimmune disorders, skin disorders, tumors, parasitic and fungal infections, and adrenal disorders are potential triggers for eosinophilia.
Eosinophilia can be due to varied reasons. Although it narrows down, it does not pinpoint the cause. Hence it is advisable to correlate with the presenting symptoms and other lab tests as directed by the physician to reach a diagnosis of concern. Eosinophilia due to mutation, tumors, blood cancer, acute hypereosinophilic syndrome, some autoimmune disorders, and drug-induced hypersensitivity reactions are of high concern.
A high eosinophil count indicates the presence of an underlying disease that needs to be diagnosed and corrected soon to arrest the progression and complication of the disease. Also, prolonged eosinophilia causes chronic inflammation in the body leading to tissue damage.
There is no significant effect of deficient or zero eosinophils as the function of immunity and defense is compensated by other parts of the immune system. Usually, it does not cause any symptoms and is detected in a routine complete blood count.
A low eosinophil count or eosinopenia is usually not of serious concern unless it is accompanied by an underlying cause of excessive cortisol, sepsis (bloodstream infection), and alcoholism which are of concern.
Dairy products, soy, wheat, eggs, fish, shellfish, peanuts, and tree nuts cause allergies in some people, increasing the eosinophil count.
Stress and anxiety lead to increased cortisol levels which in turn cause reduced eosinophil count.
Eosinophilia by itself does not cause tiredness, but the cause for eosinophilia may have tiredness as one of its symptoms as in cancer, hypereosinophilic syndrome, etc. Also, a rare disorder called eosinophilia-myalgia syndrome presents fatigue as its main symptom.
DRESS (drug reaction with eosinophilia and systemic symptoms) can cause high eosinophils due to medication for urinary tract infection. Also, a high eosinophil count is observed in eosinophilic cystitis.
Nematodes like hookworm, Cysticercus, Ascaris, Strongyloides, Echinococcus, Filariae, flukes like Schistosoma, Paragonimus westermani, Fasciola, protozoans like Isospora belli, Dientamoeba fragilis, and Sarcocystis cause infection and eosinophilia.
Bacterial and viral infections and sepsis cause decreased eosinophils or eosinopenia. Tuberculosis causes eosinophilia. Parasitic infections mainly cause eosinophilia.
Treating the underlying cause of high eosinophils and discontinuation of drug in drug allergy, adequate treatment for asthma, eczema, and allergies, anti-parasitic medications, and avoiding potential allergens reduce eosinophilia. Corticosteroid, Imatinib, Hydroxyurea, and Interferon Alpha are the current choice of drug therapies to treat eosinophilia.
Eosinophil counts above 1500 per microliter are known as hypereosinophilia. Persistent hypereosinophilia with organ involvement causes hypereosinophilic syndrome. Most commonly, the respiratory tract, central nervous system, skin, and heart are involved. This is a rare entity in children and can be due to chromosomal abnormalities or myeloproliferative disorders and cancer. Treatment options include steroids, Vincristine, Mepolizumab, Hydroxyurea, Interferon Alpha, and Imatinib.
Last reviewed at:
11 Aug 2022 - 2 min read
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Dr. Goswami Parth Rajendragiri
Pathology
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