Could an elevated eosinophil count lead to severe asthma with chronic rhinosinusitis and nasal polyps?

Question

Hello doctor,

I am a 37-year-old female, and I have been dealing with chronic rhinosinusitis with nasal polyps (grade 1) for the past 14 years. Despite undergoing various allergy tests, my results have always been negative, and my IgE levels are within the normal range. Spirometry results are normal, and a sinus CT scan revealed mild to moderate thickening of the maxillary mucosa. My treatment involves nasal steroids (Flixonase or Mometasone) and Cetirizine.

I have some concerns about my condition that I would like to understand better. While I do not currently experience any asthma symptoms, I am cautious because my father has asthma and polyps. My main question revolves around my high eosinophil count, which consistently hovers around 0.5 or 0.6. I have read studies suggesting that counts over 0.3 are associated with severe asthma.

I am wondering whether I should be concerned about developing severe asthma in the future due to my elevated eosinophil count. Does this imply that my chronic rhinosinusitis with nasal polyps has an eosinophilic nature, and I might be predisposed to asthma? I am particularly worried because my eosinophil count seems notably higher than that of the general population.

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Thank you for your query. I read your query and understood your concern.

According to your statement, you have been suffering from chronic rhinosinusitis with nasal polyps for the last 14 years. According to your blood report that is provided here (attachment removed to protect the patient’s identity), your eosinophil count is 0.5 cells/mcL, where the normal value is mentioned between 0 and 0.4. First of all, most lab reports mention that 0 to 0.5 or 0.6 x 10^9/L is considered the normal range of eosinophil count.

As you have rhinosinusitis, from my point of view, your eosinophil count is normal or, according to your lab range, mildly elevated, as your lab range is 0 to 0.4. In your case, the eosinophil count can be mildly elevated as you have rhinosinusitis, which is quite a common scenario. As you have a positive family history of bronchial asthma, your physician has predicted that you are prone to develop bronchial asthma in the long run, which does not indicate that you will definitely develop bronchial asthma in your lifetime. It is possible that your body's immune system will become hampered or decline in the long run in your older age due to any causes.

From my point of view, your present eosinophils count is quite normal for you due to having rhino sinusitis. So, there is nothing to be worried about at present.

I hope my advice will be helpful. Feel free to reach out if you have any further queries.

Thank you.