Eosinophilia Definition
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.
- In asthma, bronchoconstriction occurs due to allergens like dust, pollen, mites, cold, etc. So, the patient is seen to have dyspnea problem as well.
- Hay fever is a form of allergic rhinitis.
- Drug allergy (Sulphonamides, Allopurinol, antiepileptic drugs, etc).
- Food hypersensitivity.
2. Parasitic infestations: Following parasites can lead to high eosinophils.
- Ascariasis.
- Ancylostoma duodenale.
- Enterobiasis.
- Taenia solium.
- Filariasis.
- Hydatid cyst.
3. Skin disease:
- Eczema.
- Scabies.
- Pemphigus.
- Psoriasis.
- Contact dermatitis.
4. Pulmonary eosinophilia.
5. Miscellaneous:
- Hodgkin's lymphoma.
- ALL (acute lymphoblastic leukemia).
- CML (chronic myeloid leukemia).
- Eosinophilic gastritis.
- Esophagitis.
- HIV infection.
Eosinophilia Diagnosis
- The diagnosis of eosinophilia is made by CBC (complete blood count) with a differential count.
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After eosinophilia is confirmed, the underlying cause should be searched for.
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For ruling out underlying cause, a medical history is taken and then accordingly investigations are done such as:
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Chest X-ray and spirometry for asthma.
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Liver and kidney profile test.
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Stool analysis and serological test for parasitic infestation.
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Allergy testing to find causative allergen.
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Peripheral smear examinations and bone marrow study to rule out a myeloproliferative neoplasm.
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Elisa test for HIV (human immunodeficiency virus).
So, according to need various tests are done.
Eosinophilia Treatment
- 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.