Eosinophilia is the technical name for a higher number of eosinophils. Eosinophils are a type of white blood cell that break down substances in the body such as parasites and are involved in allergic reactions.
If you have eosinophilia, your symptoms will be partially determined by the cause of the increased amount of eosinophilia. If your eosinophil count is slightly elevated, you may not have any symptoms. Common symptoms include:
- Diarrhea with parasitic infections.
- Runny nose, especially associated with allergies.
There are many reasons why you may have a high eosinophil count. Some of the causes are benign and require little treatment. It is not uncommon for more patients to be temporary and disappear without treatment. Let's now look at some of the reasons.
- Parasitic Infections: Worldwide, the most common cause of eosinophilia is parasitic infection. These infections include schistosomiasis, trichinosis, strongyloidiasis, and ascariasis. These parasites can be found all over the world, including the United States. Travel history is an important part of screening for eosinophilia, although the absence of recent travel does not rule out parasitic infections.
- Drug reactions: Medications can cause eosinophilia, sometimes without obvious signs or symptoms. The most common medications associated with eosinophilia include antibiotics (penicillin, cephalosporins), nonsteroidal anti-inflammatory drugs (aspirin, ibuprofen), phenytoin (an anticonvulsant), and allopurinol (used to treat gout). The most serious form is called a drug reaction with eosinophilia and systemic symptoms (DRESS). Fortunately , most people will not have these reactions while taking these medications.
- Atopy: Atopy is a special reaction that occurs in the body. Generally, atopy refers to asthma, seasonal allergies (also called allergic rhinitis), and eczema. It is not uncommon for someone to have more than one of these conditions, as they are related. These are some of the most common causes of mild to moderate eosinophilia, especially in children. Likewise, food allergies can also cause an increase in the number of eosinophils.
- Eosinophilic esophagitis (EoE): This is a disease characterized by the proliferation of eosinophils in the esophagus, which usually does not contain eosinophils. About 50% of people with EE also have a higher number of eosinophils in their blood .
- Hypereosinophilic syndromes. Hypereosinophilic syndromes (HES) are a group of diseases characterized by a very high number of eosinophils and evidence of organ damage by a large number of eosinophils. The skin, lungs, and gastrointestinal tract are often affected. HES can be primary (also called neoplastic), secondary (reactive), or idiopathic (cause unknown) .
- Chard-Strauss syndrome: Chard-Stouss vasculitis, now called eosinophilic granulomatosis with polyangiitis, can cause eosinophilia. People with this condition first develop asthma and other lung problems, then eosinophilia, and finally vasculitis , an inflammation of the blood vessels.
- Cancer: There are several types of cancer, especially blood cancers, which are known to increase the number of eosinophils. These include a rare type of acute myeloid leukemia (AML) called eosinophilic leukemia. Other causes include multiple myeloproliferative neoplasms (such as essential thrombocythemia, polycythemia vera), B-cell and T-cell lymphoma, and adenocarcinomas of the gastrointestinal tract, lungs, and cervix.
Like most blood diseases, eosinophilia is detected by a general blood test . Eosinophils are one of the white blood cells and are found in a portion of the CBC called the differential. The differential shows how many white blood cells of each type (neutrophils, lymphocytes, monocytes, eosinophils, and basophils ) are present in the blood.
Once eosinophilia is diagnosed, your healthcare provider will begin work to determine the cause, which sometimes requires a referral to a hematologist. Eosinophilia can be classified by the number of eosinophils (the absolute number of eosinophils) .
- Light: 500-1500 cells / ml.
- Moderate: 1500-5000 cells / ml
- Severe:> 5000 cells / ml
Determining the cause of your eosinophilia will be based on your symptoms. Eosinophilic esophagitis can cause difficulty swallowing, chest and / or abdominal pain, vomiting, or food stuck in the esophagus. Diagnosis requires a biopsy of the esophagus. Many parasitic infections are diagnosed by taking and testing stool samples. There may not be a test to determine if a drug is causing your eosinophilia. If the eosinophil count returns to normal after stopping the drug, it is generally assumed that the drug was the cause.
As with diagnostic tests, treatment is determined by the cause of the eosinophilia. The following options are possible :
- Follow-up: If you have mild eosinophilia, repeat laboratory follow-up may be recommended.
- If a drug causes an increase in the number of eosinophils, it can be stopped.
- Maximum treatment for asthma, eczema and allergies
- Parasitic infections are treated with antiparasitic drugs.
- Steroids like prednisone can be used to treat hypereosinophilic syndromes.
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Hypereosinophilia is a scary word. Fortunately, for most people with this condition, it is temporary and requires little to no treatment. Some may need a referral to a specialist for diagnosis and treatment. If you have additional concerns, be sure to discuss them with your doctor.