Do high eosinophil count and low Hb level indicate allergic reaction?

Question

Hi doctor,

The patient is a 27-year-old female who has been suffering from hay fever for some years. Now, she has now been referred to the chest clinic with breathing difficulties. She has commented that her condition appears to worsen when she visits her friend, who is a cat owner. On examination, she has wheezing sounds in her lungs and inflamed sinuses. Her Hb is low, and her eosinophil count is high, but other WBC differential counts, platelets and MCV are normal. I was unsure if the hemoglobin being low is seen with allergies or if this could be a wholly separate matter. Are the high level of eosinophil and low Hb related to the visit of the cat or indicate something else?

Answer 1

Hi,

Welcome to icliniq.com.

The history and reports are suggestive of allergic bronchitis, or an asthma-like condition. The wheezing is indicative of bronchoconstriction (attachment removed to protect patient identity).
Low hemoglobin value was evaluated separately with peripheral smear examination and according to the PS report, the further workup will be decided.
For your allergic condition, I suggest Fexofenadine and Montelukast combination drugs for ten days.
For immediate relief from your bronchoconstriction, I suggest nebulization with Levosalbutamol and Budesonide twice daily for three days or MDI (metered dose inhaler) inhaler therapy. Consult your doctor, discuss with him or her, and take treatment with consent.
You had visited the cat owners home, and high eosinophil confirmed the allergy. Low hemoglobin value should be evaluated separately after your examination. Consult a physician for examination with keeping all this in mind.