Eosinophilic disorders are blood conditions typically characterized by too many eosinophils — a type of white blood cell — in the bloodstream and sometimes by the presence of eosinophils in organs or tissues where they are not normally found. At Seattle Cancer Care Alliance (SCCA), our team of experts provides comprehensive diagnostic and medical care for people with eosinophilic disorders.
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What is eosinophilia?
Eosinophils generally account for less than 5 percent of white blood cells circulating in the bloodstream. They help fight off certain infections, and they are involved in hypersensitivity reactions of the immune system. The number of eosinophils in the blood can rise during a normal response to allergic reactions, fungal and parasitic infections, medications, and some types of cancer.
An abnormal increase in eosinophils, called eosinophilia, can result from an acquired genetic defect in the cells that make eosinophils (bone marrow precursor cells), or it can occur as an inappropriate response by the body to immune cells called T lymphocytes (T-cells). Eosinophilia also can occur in conjunction with myeloproliferative neoplasms and lymphoproliferative disorders.
What is hypereosinophilic syndrome?
Conditions in the group of disorders known as hypereosinophilic syndrome (HES) develop when the body consistently and inappropriately produces a high number of eosinophils with no apparent underlying allergic or drug reaction or other trigger. Though it can affect anyone, HES is more common in men over 50.
A needless surplus of eosinophils can infiltrate and affect any organ in the body, especially the gastrointestinal tract, skin, lungs, heart, and liver.
Symptoms and diagnosis of eosinophilia & hypereosinophilic syndrome
Symptoms of HES depend largely on the organs affected, the severity of the disease, and any associated medical conditions. Common red flags include fever, rash, itching, coughing, wheezing, shortness of breath, diarrhea, abnormal blood counts, and enlarged lymph nodes or organs.
Because many different problems can cause high numbers of eosinophils in the blood, eosinophilia alone is not enough to diagnose of HES. Instead, doctors consider several factors, including the degree and duration of eosinophilia and the affect on organs.
SCCA offers a full array of services to diagnose eosinophilia and HES. Doctors use blood tests, biopsies of affected organs, and sometimes a bone marrow biopsy (examining a small sample of marrow taken with a hollow needle) to try to identify the underlying cause of the high eosinophil level.
To rule out allergic or drug reactions that might be affecting eosinophil levels in your blood, your doctor may ask you to temporarily stop taking certain medications or supplements. You might also undergo allergy testing.
If these steps don’t reveal an underlying cause and your doctor suspects you have HES, you may have genetic tests to look for abnormal bone marrow precursor cells and abnormal T-cells.
Eosinophilia & hypereosinophilic syndrome treatment
SCCA’s team of doctors provides a comprehensive range of treatment options for eosinophilia and HES. While treatments vary depending on the organs involved and the severity of symptoms, the goals remain the same:
- To decrease the number of eosinophils
- To prevent organ damage
- To slow disease progression
Your doctor may prescribe drugs that suppress the growth of eosinophils, the action of eosinophils, or abnormal T-cells, if present. Systemic corticosteroids are often needed to combat severe rash, fluid retention, and other systemic symptoms. In some patients, corticosteroids alone are enough to manage the condition; others need stronger immunosuppressive therapies.
For more information about eosinophilic disorders, this resource may be helpful: