Ever wondered about eosinophils and their role in your body? They are white blood cells that fight infections and diseases. Eosinophils eat harmful substances like parasites1. But too many can cause problems, especially in asthma and allergies1.
A high eosinophil count means you might have allergies, parasites, or other health issues2. Sometimes, a high count is found by accident during a blood test. But very high counts can harm your organs1.
Parasites and medicine allergies often cause high eosinophil counts. This can lead to serious damage, known as hypereosinophilic syndrome1. This condition might be linked to cancer1. Knowing about eosinophils and high counts is key to staying healthy.
Key Takeaways
- Eosinophils are white blood cells that help protect the body from infections and diseases.
- A high eosinophil count (eosinophilia) may indicate various disorders, such as allergic diseases, parasitic infections, and certain cancers.
- Slightly elevated eosinophil counts usually do not cause symptoms, but very high counts can lead to tissue inflammation and organ damage.
- Common causes of eosinophilia include parasites and allergies to medicines, with hypereosinophilia potentially causing hypereosinophilic syndrome.
- Understanding eosinophils and the causes of high counts is important for maintaining health and well-being.
Understanding Eosinophils and Their Function
Eosinophils are a special kind of white blood cell. They help fight off infections and allergies in our body. These cells grow in the bone marrow for 8 days before they start moving in our blood3.
They travel for 8 to 12 hours. Then, they go to specific tissues where they stay for 1 to 2 weeks3.
What are Eosinophils?
Eosinophils have orange-red granules in their cells. These granules have proteins that help them work well4. A special growth factor called interleukin 5 (IL-5) helps them grow and live longer3.
In healthy people, eosinophils make up less than 7% of white blood cells. They usually have between 100 to 500 eosinophils per microliter of blood5. Their numbers can change, especially at night and in the morning5.
Stress, certain medicines, and infections can also affect their numbers5.
The Role of Eosinophils in the Immune System
Eosinophils do many important jobs in our immune system. They move to where they’re needed, trap and kill bad guys, and help fight off parasites and bacteria3.
They also help with allergic reactions and control inflammation3. They work with other cells to keep our immune system balanced4.
Eosinophils help keep our gut healthy by supporting immune cells there4. They can even help our immune system by working with T cells4. They help move around and present antigens in lymph nodes4.
They also have special proteins that fight off microbes and attract other immune cells4.
Normal Eosinophil Count Range
Understanding your normal eosinophil count is key. The normal range is less than 500 eosinophil cells per µL of blood. This is also less than 5% of the total white blood cell count6. A complete blood count can show your eosinophil levels.
Eosinopenia happens when your eosinophil count is too low. It can be caused by many things like infections, too much alcohol, stress, and steroids6. It can also happen from drinking too much alcohol or making too many steroids in your body7.
Even though a low eosinophil count is not usually a big deal, it’s still good to check your levels regularly.
But, if your eosinophil count is too high, it might mean you have health issues. Having more than 5×109/L eosinophils is called hypereosinophilia8. Eosinophilia levels can be mild, moderate, or severe6.
- Mild (500 to 1,000 eosinophils per µL of blood)
- Moderate (1,000 to 5,000 eosinophils per µL of blood)
- Severe (more than 5,000 eosinophils per µL of blood)6
It’s important to talk to your doctor about your eosinophil count. They can help figure out if you need more tests or treatment. Knowing your eosinophil count and watching for changes can help you stay healthy.
Causes of High Eosinophil Count (Eosinophilia)
Eosinophilia, or a high eosinophil count, can be caused by many things. This includes allergic reactions, parasitic infections, and some cancers. When there are more than 450 eosinophils per cubic millimeter of blood, it’s called eosinophilia9.
The severity of eosinophilia can vary. It can be mild, moderate, or severe. Severe cases are known as hypereosinophilic syndrome9.
Allergic Disorders
Allergic disorders are a common cause of eosinophilia. During an allergic reaction, eosinophils can make up 3–5% of white blood cells9. Conditions like allergies, asthma, and atopic dermatitis can raise eosinophil levels1.
Parasitic Infections
Parasitic infections also cause eosinophilia. Many parasites, especially those that invade tissues, increase eosinophil production1. Studies link eosinophilia to infections like schistosomiasis and ascariasis10.
Certain Cancers
Some cancers can also lead to eosinophilia. This includes Hodgkin lymphoma, leukemia, and certain myeloproliferative neoplasms1. AML and eosinophilic leukemia are also linked to high eosinophil counts1.
Hypereosinophilic Syndrome
Hypereosinophilic syndrome is a rare disorder. It’s marked by an eosinophil count of 1,500 mm3 or higher for over 6 months without a clear cause9. This condition can damage organs and is sometimes linked to cancers like bone marrow or lymph node cancer1.
| Cause | Examples |
|---|---|
| Allergic Disorders | Allergies, asthma, atopic dermatitis, drug allergy, hay fever (allergic rhinitis) |
| Parasitic Infections | Schistosomiasis, ascariasis, helminth co-infections |
| Certain Cancers | Hodgkin lymphoma, leukemia, myeloproliferative neoplasms, acute myelogenous leukemia (AML), eosinophilic leukemia |
| Hypereosinophilic Syndrome | Eosinophil count ≥ 1,500 mm3 for > 6 months without apparent cause |
Other causes of eosinophilia include adrenal conditions, skin disorders, toxins, and autoimmune disorders. Endocrine conditions, Churg-Strauss syndrome, and Crohn’s disease can also cause it. Eosinophilic esophagitis, eosinophilic gastroenteritis, and idiopathic hypereosinophilic syndrome (HES) are examples too1.
Symptoms of High Eosinophil Count
Most people don’t notice anything when eosinophil levels are a bit high. But, when they get really high, it can cause inflammation and damage to organs. This leads to different symptoms, depending on which organs are affected11.
Organ-Specific Symptoms
Symptoms can change based on which organs are inflamed. For example, skin issues might cause a rash or intense itching. Lung problems can lead to wheezing, shortness of breath, and a cough that won’t go away.
Heart issues might make you feel very tired and have trouble breathing. This is a sign of heart failure. You might also feel pain in your throat or stomach if the esophagus or stomach is inflamed11.
In cases of hypereosinophilic syndromes (HES), the skin, lungs, and stomach are often affected. This can cause serious damage to these organs12.
General Symptoms
People with high eosinophil counts may also have general symptoms. These can include:
- Weight loss
- Fevers and night sweats
- Fatigue
- Chest pain
- Swelling
- Stomachache
- Pain and weakness
- Confusion and coma (in severe cases)
The severity of symptoms can vary. It depends on the cause of the high eosinophil count and the extent of inflammation and organ damage. If symptoms get worse quickly or you have trouble breathing, seek medical help right away11.
Diagnosing High Eosinophil Count
If you think you have a high eosinophil count, your doctor will run tests. These tests help find the cause. They can check for diseases or infections13.
Diagnosing eosinophilia often means blood tests and sometimes biopsies.
Blood Tests
A complete blood count (CBC) is the main test for eosinophils. Adults usually have less than 500 eosinophils per microliter of blood13. More than 500 might mean you have eosinophilia.
Eosinophilia levels can be mild, moderate, or severe. This depends on the number of eosinophils in your blood13.
High eosinophil counts can point to hypereosinophilic syndrome. This is when blood tests keep showing high eosinophils and symptoms match. Studies show that eosinophil counts can vary, helping doctors keep an eye on patients14.
Biopsies
Doctors might take a tissue sample for a biopsy. This helps find eosinophil-related disorders. A biopsy can show eosinophils in the affected organ, helping diagnose.
Eosinophilia can be linked to many conditions. This includes scabies, myiasis, and eosinophilic pustular folliculitis. Blood tests can spot these issues14.
| Diagnostic Test | Purpose |
|---|---|
| Complete Blood Count (CBC) | Measures the number of eosinophils in the blood |
| Tissue Biopsy | Shows eosinophils within the affected organ |
After finding a high eosinophil count, treatment starts. It might include medicines for infections or allergies. For severe cases, corticosteroids are used. More tests might be needed for autoimmune diseases or other conditions13.
Your doctor will choose the best tests based on your symptoms and medical history.
Eosinophilic Disorders
Eosinophils in high numbers can cause various eosinophilic disorders. These conditions are diagnosed by where the eosinophils are found15. They can affect the esophagus, stomach, small bowel, colon, lungs, heart, blood, and other organs15. Let’s explore some common eosinophilic disorders.
Eosinophilic Asthma
Eosinophilic asthma has high eosinophils in the lungs. It’s often more severe than regular asthma. Symptoms include coughing, wheezing, and shortness of breath.
If not treated, it can lead to eosinophilic pneumonia. This causes more respiratory problems.
Eosinophilic Esophagitis
Eosinophilic esophagitis (EoE) is an inflammatory condition of the esophagus. It’s often caused by food allergies. Symptoms include difficulty swallowing and chest pain.
Eosinophils in the esophagus without a known cause are a sign of EoE16. There are treatments and information available for EoE16.
Eosinophilic Gastroenteritis
Eosinophilic gastroenteritis is inflammation of the stomach and intestines. It’s caused by eosinophils. Symptoms include abdominal pain and nausea.
Eosinophilic colitis affects the large intestine, while eosinophilic enteritis affects the small intestine. These conditions can cause discomfort and may lead to weight loss.
Other disorders include eosinophilic cardiomyopathy and hypereosinophilic syndrome (HES). HES is a rare disorder with high eosinophil counts and tissue damage16. These conditions require long-term management and can affect quality of life15.
Treatment Options for High Eosinophil Count
When dealing with high eosinophil counts, the aim is to cut down inflammation and ease symptoms. The right treatment depends on the condition and how bad the symptoms are. Let’s look at some common ways to handle high eosinophil levels.
Corticosteroids
Oral corticosteroids are often the first choice for treating eosinophilic disorders. They calm down the immune system and reduce inflammation. These drugs can greatly lower eosinophil counts and ease symptoms17.
In some cases, topical steroids are used for specific treatments, like eosinophilic esophagitis18. It’s key to remember that while corticosteroids help a lot, long-term use can have side effects. So, it’s important to keep a close eye on them with your doctor.
Immunosuppressive Agents and Monoclonal Antibodies
If corticosteroids don’t work or more treatment is needed, immunosuppressive agents might be used. These drugs adjust the immune system’s response and cut down eosinophil production. Monoclonal antibodies like dupilumab are also showing promise in treating eosinophilic esophagitis18.
Dupilumab (Dupixent) got FDA approval for this condition in May 202219. These targeted treatments can help manage symptoms and boost life quality for those with eosinophilic disorders.
Here’s a table summarizing some common treatment options for eosinophilic disorders:
| Disorder | Treatment Options |
|---|---|
| Eosinophilic Esophagitis (EoE) | Topical steroids, dietary therapy, monoclonal antibodies (dupilumab)1819 |
| Eosinophilic Gastritis (EoG) | Systemic steroids, dietary therapy (efficacy not yet known)19 |
| Eosinophilic Gastroenteritis | Oral corticosteroids, dietary changes17 |
| Hypereosinophilic Syndrome (HES) | Systemic steroids19 |
Leukapheresis
In severe cases of hypereosinophilic syndrome or when other treatments fail, leukapheresis might be considered. This process removes extra eosinophils from the blood. It’s like dialysis but for blood. Leukapheresis can quickly ease symptoms and lower eosinophil counts, but it’s mainly for complex cases.
It’s vital to work closely with a healthcare provider to create a treatment plan that fits your needs. Making lifestyle changes, like avoiding triggers and eating well, can also help manage eosinophilic disorders18. With the right treatment and care, it’s possible to control symptoms and improve well-being when facing high eosinophil counts.
Complications of Untreated High Eosinophil Count
A high eosinophil count can cause serious problems if not treated. This is especially true for hypereosinophilic syndrome. Eosinophils, which are usually less than 5% of white blood cells, can damage organs when there are too many (over 1500/mm^3) for a long time20. The heart is very vulnerable, leading to Löffler endocarditis, a serious inflammation.
This inflammation can cause blood clots, heart failure, heart attacks, and problems with heart valves21. Other organs like the lungs, liver, skin, and nervous system can also be affected. High eosinophil counts are linked to heart disease, stroke, and death22. Patients with certain types of hypereosinophilic syndrome may face endomyocardial fibrosis, a dangerous condition21.
It’s important to treat eosinophilia quickly to avoid damage to organs. Without treatment, the disease can be mild or deadly, depending on several factors20. Working with a doctor is key to finding the cause and preventing serious problems.