Eosinophilia

Written by M Y Karim, lecturer in immunology

What can your doctor do?
Once a diagnosis has been made your family doctor can help to establish the cause of the condition. Simple skin or blood tests may be performed to confirm specific allergies, such as pollen or dust mite allergy. Parasitic infection can be determined by analysing blood and stool samples.

You may also be asked whether you are taking any new medicines in case it is the result of a side effect, and about foreign travel for possible parasitic infection.

A pet dog can occasionally be a source of a parasitic infection called Toxocara canis.

When to refer to a specialist?
If your GP cannot make a diagnosis, then you may be referred to a hospital specialist. The choice of specialist will depend on your symptoms. But it will usually be a haematologist (blood disorder specialist).

Further tests may include blood tests to measure levels of antibodies, chest X-ray, CT scans of the chest and abdomen, skin or lung biopsies, examination of the bone marrow, and bronchoscopy.

Treatment
Treatment tackles the underlying cause of the condition, whether it is an allergy, a medicine reaction, or a parasitic infection. These treatments are usually effective, and fairly non-toxic.

Treatment for hypereosinophilic syndrome is oral corticosteroid therapy, usually starting with prednisolone at single daily doses of 30-60mg. If this is not effective, a chemotherapeutic agent is administered.

Living with eosinophilia
In most cases, when the cause of eosinophilia is identified, treatment significantly reduces the symptoms of the condition. Corticosteroids, both local (inhaled, topical), and systemic (oral, intramuscular, intravenous), are used to manage several allergic conditions and reduce the number of eosinophils.

In hypereosinophilic syndrome there is a high risk of damage to the heart and other major organs. In some cases a blood cell tumour known as a T-cell lymphoma may also develop, so patients must be carefully monitored.

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