What is aneosinophilia? Symptoms of the disease and its treatment

Eosinophils are considered to be markers of parasitic infestations and allergic reactions. An increase in their levels is called eosinophilia. This condition is accompanied by some physiological and many pathological changes. Exceeding the norm requires attention in both adults and children, as it can signal the development of a life-threatening disease.

Eosinophils are a group of granulocytic leukocytes discovered and described in 1846 by T. W. Jones. The functions and features of these white blood cells have not been fully studied even today. Despite the ability of cells to phagocytose, they are poorly involved in the fight against infections.

Role and functions of cells

Eosinophils get their name because of their ability to stain with the acidic dye eosin, with which the bodies are isolated in a smear for further counting. They are produced by the bone marrow and mature in about 9 days. Later, eosinophils enter the bloodstream and circulate in the body in case of penetration of foreign proteins. Cells are capable of:

• extravasation - penetration through the walls of blood vessels;
• chemotaxis - movement towards pathological foci (can change position chaotically);
• phagocytosis - act as microphages (they absorb relatively small cells, toxins, particles).

After 12–24 hours, the bodies move into peripheral tissues. The highest concentrations are observed on the mucous membranes, submucosal layer of the stomach wall, and small intestine. Here the bodies continue to perform their protective functions, waiting for a collision with foreign genetic material. The proportion of circulating cells is miniscule. For each eosinophil there are up to 300 precursor cells that mature in the bone marrow and from 100 to 300 tissue bodies. Differing from neutrophils, which react against any infections, as well as from actively phagocytic monocytes, eosinophils are weakly involved in standard protective reactions. Their main functions are recognized:

• cytotoxic qualities (can produce substances that have a detrimental effect on some parasites and on the body’s own cells);
• stimulate the sensitivity of IgE-specific receptors (which causes severe allergic reactions, including the immediate type);
• can absorb and release allergy mediators (activate or suppress manifestations of hypersensitivity);
• involved in eliminating the consequences of allergies;
• participate in antitumor immunity.

In peripheral tissues, protective bodies live up to 12 days. Then they are replaced by new mature cells.

What are eosinophils and what do they do in the body?

Eosinophils are blood cells that belong to the group of leukocytes. Leukocytes in the blood are a diverse group of cells that differ in their structure and functions. The main function of these cells is to protect the body.

Eosinophils are part of the immune system. They are responsible for protecting the human body from foreign agents: bacteria, viruses, allergens.

Eosinophils easily penetrate the vascular bed. This allows them to easily move and reach the desired place when a foreign agent enters the body. These cells are able to absorb and destroy it. True, they are able to do this only with relatively small particles.

Eosinophils have a high cytotoxic effect - their main purpose is to fight parasites. It is involved in the formation of antiparasitic immunity.

This type of leukocyte is able to absorb histamines, which play an important role in the formation of an allergic reaction. This allows not only to provoke the activation of the immune system, but also to suppress it due to excessive production of substances that can cause harm to the body.

Normal levels of eosinophils in the blood

The cell level is determined during a general blood test with a leukogram. In a conventional study, the results indicate only the total number of leukocytes, without distribution into groups. The leukocyte formula norms are almost identical for adults and children, representatives of both sexes.

Table - Leukogram norms for adults

The eosinophil count in an adult is considered normal from 0.02 to 0.3*10⁹/l. For children, the upper threshold is slightly higher (0.7*10⁹/l). The percentage of cells among white blood cells varies depending on the age of the patient.

Table - Normal percentage of eosinophils in children

To assess the blood picture in children, only a percentage indicator is often considered. The absolute value (MON abs.) in young patients significantly exceeds the norm for adults, which is only rarely associated with diseases.

It is typical that the number of peripheral blood cells changes throughout the day. Minimum concentrations are observed in the morning. The values ​​increase after physical activity and eating food. The maximum is reached when a person falls asleep (before midnight), and then gradually decreases.

What does the eosinophil count indicate?

An increase in the number of cells above normal is called eosinophilia. This is a laboratory term that is considered a marker of certain diseases. It is impossible to make a diagnosis based on the results of the CBC. A full examination will help determine the nature of the disease. Based on the percentage of eosinophils, three degrees of severity of the condition are distinguished.

Table - Types of eosinophilia

The circulation of a large number of eosinophils in the peripheral blood almost always means stimulation of their production in the bone marrow, since in a short time the cells pass into the tissue bed. Active synthesis of bodies can be provoked by:

• pathogenic microflora;
• encounter with allergens;
• parasitic infestation;
• the presence of atypical own cells;
• tissue breakdown;
• changes in bone marrow function.

Doctors refer to the most common causes that are relevant for children and adults with the abbreviation POKAA. This means that eosinophilia is most often caused by:

• parasites;
• tumors;
• collagenoses;
• allergies;
• asthma.

It has been proven that the severity of deviations in OAC results directly depends on the intensity of development of the underlying pathological process. The more complex the disease, the higher the level of eosinophils will be found in the patient. Based on cell indicators, you can monitor the effectiveness of eliminating causes. Analysis deviations can cause some physiological changes in the body, which you need to know when planning a laboratory visit:

• evening readings may exceed the norm by 30% (which is taken into account if the analysis is carried out urgently);
• consumption of large amounts of sweets, alcohol, protein foods of animal origin (it is better to exclude them when preparing for the study);
• the amount is slightly increased in the first days of menstruation, sharply decreases after ovulation (but does not go significantly beyond the normal limits);
• the analysis is influenced by medications (hormonal drugs, antituberculosis, anticonvulsants, antihistamines, diphenhydramine, papaverine, aminophylline, B vitamins, etc.).

Basopenia during pregnancy

BAS may be reduced to 0 at the beginning of pregnancy. During this period, the volume of circulating blood in the woman’s body increases, and the percentage of basophilic leukocytes decreases. Absolute BA at the same time is above 0 and most often is within the physiological norm.

During pregnancy, BAS levels are reduced in women suffering from folate deficiency anemia. A high need for vitamin B9 is observed in the growing fetus, the consumption of folic acid for hematopoiesis in the mother and fetus is increased, and the vitamin is also required for the construction of the placenta.

The results of the basophil test for anemia caused by a lack of vitamin B12 were reduced to almost 0%. A diet containing meat, cheese, eggs, and dairy products will help restore the population level to normal values.

Preventive intake of vitamins when planning pregnancy, especially folic acid, can reduce the risk of developing anemia during pregnancy and reduce the likelihood of developmental defects in the fetus.

Agranulocytosis

When the content of granulocytes in the leukocyte formula in adults decreases to a level of 0.75*109/l, a state of agranulocytosis is indicated. The most characteristic sign for it is a sharp decrease in neutrophils, eosinophils and BA levels reduced to 0%.

The absence of leukocytes containing granules, or a decrease in their level to 0%, is noted:

• by blocking the production of these populations in the bone marrow;
• in the case of the formation of immune complexes that destroy their own cells.

The disruption of the formation of granulocytes in the bone marrow is called myelotoxic agranulocytosis, and is provoked in adults by radiation, treatment with cytostatic drugs, antibiotics gentomycin, chloramphenicol, penicillin.

Immune agranulocytosis develops under the influence of:

• inflammatory disease of the thyroid gland, autoimmune thyroiditis;
• infectious diseases - malaria, influenza, polio;
• collagenosis - systemic lupus erythematosus, rheumatism, scleroderma;
• necrotic changes in tissues - ulcerations of the oral mucosa, skin, ulcers in the stomach, intestines.

Agranulocytosis in adults is accompanied by severe clinical symptoms. High temperature, pain in the throat, joints, spasm of the masticatory muscles, difficulty when trying to swallow, severe sweating are manifestations of a decrease in the level of all types of granulocytes in the bloodstream to almost 0.

If the intestines are more affected, then painful bloating and diarrhea are observed. Basophils, neutrophils and eosinophils are reduced to 0 in necrotic ulcers in the intestine; such a decrease in the results of the analysis of granulocyte content in adults indicates the risk of perforation of the intestinal wall.

Does eosinophilia have symptoms?

Deviations in blood tests always show signs of a causative disease. By themselves, they do not have specific symptoms or change the patient’s well-being slightly (it cannot be said that it was a violation of the blood composition that became the main prerequisite).

Table - Possible symptoms of eosinophilia

Symptoms

Elevated eosinophils in the blood of an adult do not have a specific clinical picture, since this is not a separate disease. Symptoms will depend on the underlying cause.

The following symptoms may occur:

• disruption of the functioning of the gastrointestinal tract;
• relapses of chronic diseases, if any;
• skin rashes, which may be accompanied by itching, peeling, formations of various nature;
• swollen lymph nodes;
• increased or high temperature;
• symptoms of ARVI, influenza;
• disorders of the genitourinary system - frequent urination, itching and burning in the genital area, pain in the lower abdomen and groin area, foreign discharge;
• in women - menstrual irregularities;
• headaches, dizziness for no apparent reason;
• frequent cases of ARVI, protracted recovery process.

It is impossible to determine from the current clinical picture alone whether eosinophils are increased or decreased in an adult, so it is advisable to seek medical help rather than carry out symptomatic treatment.

Causes of eosinophilia

The main and most common prerequisite for an increase in the number of eosinophils is considered to be parasites. The combination of parasitic infestations and abnormalities in clinical blood tests occurs so often that doctors primarily consider the possibility of infection with worms. High levels of eosinophils may be due to the following diseases:

• ascariasis;
• filariasis;
• toxocariasis;
• schistostomiasis;
• amoebiasis;
• paragonimiasis;
• trichinosis;
• echinococcosis;
• malaria;
• opisthorchiasis;
• strongyloidiasis;
• enterobiasis.

Such reasons are relevant for adults and children. However, eosinophils are not always elevated in the presence of parasites in the body. The cell count does not change when infected with Ciardia Lamblia, but this development is considered more of an exception.

Eosinophilia, provoked by allergies, is accompanied by an increase in cell counts of more than 0.6 * 10⁹/l. In this case, the values ​​do not exceed 1*10⁹/l. When the level is higher, other causes must be considered, since sensitivity reactions cannot provoke such significant changes. Eosinophilia accompanies:

• hay fever (hay fever) - allergic manifestations to flowering plants;
• bronchial asthma;
• allergic fasciitis and myositis - inflammation of the muscles and surrounding fascia;
• serum sickness - allergy to vaccines;
• rhinitis (runny nose);
• drug reactions;
• Quincke's edema;
• hives

A significant increase in the level of eosinophils in the blood requires a comprehensive examination for malignant diseases. Neoplasms may contain protective cells; such tumors have a more favorable prognosis. Eosinophilia accompanies the following types of cancer:

• nasopharynx;
• lungs;
• large intestine;
• stomach;
• uterus;
• thyroid gland;
• lymphatic system;
• bone marrow.

Specific tumor markers help determine the location of the malignant focus. Diseases of the hematopoietic system are diagnosed by bone marrow biopsy. Eosinophilia accompanies acute eosinophilic, lympho- and myeloblastic leukemia. The combination of abnormal blood flow with hepatosplenomegaly and lymphadenopathy may indicate Hodgkin's disease.

In case of serious tumors accompanied by tissue destruction, basophil levels also increase. The level of eosinophils is taken into account to monitor the effectiveness of therapy. Its increase may signal a relapse of the disease or the appearance of metastases.

Cell values ​​rarely change with a cold. Their indicator should remain unchanged during pregnancy and menstruation, while the indicators of lymphocytes, monocytes and platelets may change.

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Autoimmune eosinophilia

An excessive concentration of immune cells in the blood can be caused by immune attacks on the body's own tissues. The autoimmune nature of the abnormalities is observed in eosinophilic syndrome. This disease is more common in young men and women and has a poor prognosis. The diagnosis is made if:

• the indicator exceeds 1.5*10⁹/l for longer than six months;
• there are no objective signs of allergies or the presence of parasites in the body;
• multiple lesions of internal organs develop.

Eosinophilic syndrome is manifested by increased body temperature, chills, decreased appetite, and weight loss. During the examination, an enlargement of the spleen and liver, damage to the heart valves, heart failure, and disturbances in the functioning of the central nervous system may be detected.

Eosinophilic myositis can be part of the syndrome described above or be an independent disease. It is characterized by a pronounced increase in the level of eosinophils in the peripheral blood. It differs from other types of myositis by the presence of rashes in the projection area of ​​the affected muscle. Eosinophilic fasciitis is similar in manifestations to scleroderma, but it begins acutely, appears for the first time after unusual types of stress, and is corrected with the help of glucocorticoids.

Drug-induced eosinophilia

Many medications have side effects, including changes in your blood patterns. These include drugs used to treat infectious diseases:

• Penicillins;
• Cephalosporins;
• Doxycycline;
• Gentamicin;
• Streptomycin;
• Rifampicin.

Eosinophilia can be provoked by Allopurinol, Spironolactone, Ranitidine, Enalapril, Warfarin, Carbamazepine. Changes in indicators are observed after hemodialysis, radiation exposure, and administration of the hepatitis A vaccine.

Hereditary pathologies

Violations of indicators can be detected in newborns with genetically determined diseases. These include benign eosinophilia, familial histiocytosis, and congenital immunodeficiencies. As a rule, these disorders are detected soon after the birth of a child or in infants during the first year of life. Some chromosomal abnormalities may predispose to the formation of malignant tumors.

Idiopathic forms

Sometimes the reasons for changes in the blood picture cannot be determined. An example is constitutional eosinophilia, which is more often detected in premature infants. It goes away on its own as the baby’s weight normalizes.

With Loeffler's syndrome, the formation of single or multiple infiltrates in the lungs is observed. They form suddenly, resolve on their own, and the course of the pathology is considered benign. During an exacerbation, the level of leukocytes may increase, and the percentage of eosinophils increases to 70%. Loeffler's disease is also called endomyocardial fibrosis. The condition is accompanied by changes in the endocardium, valve damage, stenosis, a decrease in the volume of both ventricles, and the development of heart failure. The prognosis for patients is unfavorable.

Common causes in children

Eosinophilia occurs in newborns after Rh conflict with the mother, during intrauterine infection, infection with staphylococcus and fungi shortly after birth.

In children over 1 year of age, changes in test results may be due to an allergic reaction, atopic dermatitis, or allergies to medications. In school-aged children and adolescents, viral diseases (chickenpox, for example) and infection with worms are considered common causes. Deviations in the analysis can be observed for some time after the illness; they disappear after the body has fully recovered.

Despite the list of the most common causes, autoimmune diseases or malignant tumors cannot be excluded. To accurately establish the nature of the deviations, an examination will be required.

What to do in case of a “bad” analysis?

The doctor who ordered the study should read the results of the OAC. If a person passes the test on his own, violations should be addressed to a pediatrician (if this is a child) or a therapist. It is important not only to study indicators that are outside the normal range, but also to correlate them with the values ​​of other blood cells.

Eosinophilia and elevated ESR may indicate a disease accompanied by an inflammatory process. High levels of eosinophils and low platelets accompany viral infections and bone marrow pathologies. Diseases of the hematopoietic system are indicated by an increase in the level of eosinophils and a change in hematocrit. Cells can be detected in biopsies and various biological fluids. This helps in identifying the place where toxins enter the body or the location of malignant tumors.

If there is a significant increase in eosinophil levels, you should take the CBC again. This will eliminate errors during the study or disruption of preparation for it. If violations are detected again, an examination should be started. If eosinophils are elevated, you need to take the following tests:

• blood biochemistry;
• general urine examination;
• feces for helminth eggs or blood for worm antigens;
• immunogram;
• liver tests;
• allergy tests;
• antinuclear antibody test;
• rheumatoid factor.

To clarify the analysis information, ultrasound of internal organs, CT or MRI, and fluorography of the lungs are performed. To exclude malignant diseases, tumor markers and a bone marrow or lymph node biopsy are prescribed.

Diagnostics

Determination of the level of eosinophils in the blood is carried out using a general blood test from a finger prick.

In order for the result to be correct, you must adhere to the following rules for the procedure:

• donate blood only in a calm, emotional state;
• one day before the procedure, you need to stop using medications (if possible), alcoholic beverages, and also avoid excessive physical and emotional stress;
• If the patient is taking medications, then it is mandatory to notify the doctor about this before the test.

Not only the number of eosinophils is taken into account, but also other blood components.

The most commonly used combinations are:

• increased monocytes and eosinophils - an infectious or parasitic disease is probably developing in the body;
• eosinophils are increased and neutrophils are decreased - a consequence of taking medications, cancer, inflammatory process;
• eosinophils and basophils are increased - an allergic reaction, an infectious disease at the peak of development.

If tests confirm that the number of such cells in the blood is significantly higher than it should be based on age, then a repeat blood test and the following diagnostic measures are performed:

• general urine analysis;
• general stool analysis and parasite analysis;
• Ultrasound of internal organs;
• allergy tests.

The exact list of diagnostic measures will be determined on an individual basis.

Is it possible to treat yourself

Any disease that causes deviations of eosinophils from the norm should be treated under the supervision of a physician. Even the obvious presence of worms in the body may not be the only problem. In addition, some parasites produce toxins with carcinogenic properties, and allergic reactions lead to autoimmune pathologies. If the risk is detected in a timely manner, it is possible to carry out the most effective and safe therapy and diagnose complications in the early stages. Self-medication and the use of folk remedies are fraught with delay in treating truly dangerous diseases that can threaten the patient’s life.

FAQ

Question: What is eosinophil cationic protein? How and why is it defined?

Answer: A cationic protein is a specific substance that acts as a mediator for eosinophils and is released from their granules when immunoglobulin E comes into contact with allergens. The indicator is measured in blood serum. The value is important for diagnosing most types of allergies (food, contact, bronchial asthma, atopic dermatitis, allergic rhinitis), as well as for monitoring the effectiveness of therapy.

Question: Is it possible to get vaccinated if you have elevated eosinophils?

Answer: The issue of vaccination should be resolved with the pediatrician who is monitoring the baby. It all depends on age, the presence of anxiety symptoms, and individual characteristics. In children under one year of age, the blood picture is unstable. If at this time there are no signs of allergies, viral or parasitic infections, slight deviations in eosinophils are not considered a contraindication. During periods of active sensitivity reactions, accompanied by rashes and general poor health, it is better to refrain from vaccinations.

Question: What does a rhinocytogram result in which eosinophils are highly elevated mean?

Answer: A rhinocytogram is the study of a smear from the nasal mucosa under a microscope. It helps to assess the functioning of local immunity, detect infectious diseases and other causes of inflammation of the membranes. Exceeding the norm of eosinophils always indicates an allergic origin of rhinitis. However, even if the cell level is within normal limits, an allergy cannot be ruled out. The analysis is needed for a comprehensive diagnosis of seasonal allergic reactions; its results are studied together with other information obtained during the examination.

Question: Have you heard that the level of corpuscles is checked in the urine, nose, and sputum? Why do they do this and how do blood cells end up in other fluids?

Answer: Eosinophils are everywhere. These bodies are released into the blood and eventually migrate to peripheral tissues. Large concentrations are concentrated on the mucous membranes. Here the cells are involved in local immunity. The level of eosinophils in a nasal swab, as well as in sputum, is indeed determined. This is necessary for diagnosing allergic diseases. The total number of leukocytes in the urine is counted (without defining groups). Exceeding the norm accompanies inflammatory lesions of the kidneys and urinary tract.

Question: What is better to take if the levels are only slightly elevated - an anthelmintic or an antiallergic?

Answer: Drugs from these groups cannot be taken independently in order to correct the blood picture. You need to focus on the symptoms. If the cause of the deviation is obvious, it is permissible to begin treatment, but you need to understand its nature - determine the type of parasites, detect the allergen and the method of its penetration into the body. One-time use of drugs instead of full-fledged therapy cannot lead to recovery or a decrease in the levels of protective cells in the blood.

conclusions

Eosinophils are protective blood cells from the group of leukocytes that resist allergens, parasites, and atypical cells. The proportion among all leukocytes is considered to be up to 5% and the absolute value is up to 0.3*10⁹/l. An increase may indicate:

• allergies;
• autopathology;
• malignant diseases;
• infection with worms or other parasites.

A decrease in the level of eosinophils is detected much less frequently, but may be associated with the development of oncology, chronic infectious diseases, and occurs while taking certain medications. Some conditions can threaten human life and therefore require timely diagnosis and treatment. Read more about this in the article: “Eosinophils are low - what do these blood counts indicate and what to do.”

Eosinophilia is a laboratory term, a symptom of disorders in the body. To eliminate deviations, it is necessary to determine the nature of the pathology and begin pathogenetic treatment.

Reasons for the decrease in basophils

Basophils are reduced to 0 in adults with a decrease in the barrier function of the immune system and speak of conditions such as:

• acute phase of the immune response;
• infectious diseases;
• anemia B12-deficiency, B9-deficiency;
• mental disorders;
• agranulocytosis;
• stress;
• pregnancy;
• adrenal gland diseases;
• physical stress;
• treatment with hormonal agents - prednisolone, progesterone;
• hyperfunction of the thyroid gland;
• Cushing's syndrome.

A decrease in BAS to 0% indicates general exhaustion during fasting or impaired absorption of beneficial nutrients in the digestive tract. Basophils are reduced to 0 in the first days of infection with infectious diseases.

The acute onset of an allergic reaction or infection is accompanied by active migration of basophils, eosinophils, and lymphocytes to the site of inflammation. The outflow of leukocytes from the bloodstream causes a temporary decrease in the content of all white blood cells to 0.

Such a decrease is a normal physiological reaction of the adult immune system and indicates its capacity and high reactivity.