eosinophilia - this increase in relative or absolute indicator of eosinophilic blood cells.Eosinophilia is regarded as a manifestation of various diseases and pathological conditions of transient and its recognition is a prerequisite for conducting laboratory study of peripheral blood.
In addition to changing the cellular composition of peripheral blood with a predominance of eosinophilic cells in the patient's notes the massive infiltration of various tissues and structures of eosinophils.Thus, allergic rhinitis accompanied by impregnating eosinophils nasal mucosa, while the tumor lesion pleural sheets in Skopje as defined eosinophilic exudate cells.
Under normal conditions, the amount of eosinophilic blood cells should not exceed the threshold of 0,3 × 109 / L.But laboratory blood greater focus on the percentage of eosinophils contained in relation to the total number of white blood cells, and this percentage should not exceed the limit of 10%.
Due to the fact that the eosinophilia is only a manifestation of a variety of pathological conditions, its causes must be sought in the etiopathogenesis of the underlying disease, the manifestation of which she has become.
The primary risk for this disease of blood should include pediatric patients with varying degrees of symptoms of allergic reactions from simple seasonal allergic rhinitis and hay fever to severe angioedema and serum sickness.Patients suffering from persistent form of long-term asthma are significant changes in the blood leucocyte count, and they are characterized by high eosinophilia.
In connection with the rapid development of the tourist area and visiting countries classified as disadvantaged in relation to parasitic and parasitic infestations, an increasing number of patients with eosinophilia are signs of parasitic diseases (ascariasis, schistosomiasis, malaria, and other).
vast majority of dermatological diseases is accompanied by an increase in the number of eosinophils in the peripheral blood and in such pathologies should include eczema, dermatitis herpetiformis, and ringworm.
Separately should consider various forms of pulmonary diseases accompanied not only by an increase of eosinophilic blood cells in the circulating blood stream, and eosinophilic infiltration of the lung parenchyma.Pulmonary eosinophilia has peculiarities of respiratory disorders and specific diagnostic features, so patients with this pathology require individual approach to the use of therapeutic measures.
large group of patients with eosinophilia are patients diagnosed with cancer with carcinomatosis stomach, thyroid cancer and malignant tumors of the pelvic organs.
End-stage immunodeficiency diseases show significant changes in the formula of white blood, including increased levels of eosinophilic blood cells.
long for autoimmune diseases and rheumatic nature in the form of rheumatoid arthritis, scleroderma and eosinophilic fasciitis, sooner or later provoke eosinophilia.
So-called transient eosinophilia can provoke long-term use of certain drugs pharmacological groups, which include: anti-TB drugs, antibiotics penicillin group, a sulfonamide.
symptoms of eosinophilia
eosinophilia does not have its own specific symptoms and laboratory signs is likely, therefore, it is characterized by major clinical symptoms of the disease, against which any changes in the content of eosinophils in the blood.
Thus, when jet diseases of autoimmune origin patients complained of progressive weight loss is not associated with changes in diet, intermittent episodes of attacks of fever hectic type, constant aching pain in the large and small joints that are not related to physical activity.The primary objective examination of the patient with eosinophilia autoimmune origin accompanied by a definite increase in the parameters of the spleen and liver, heart failure in the form of ascites, peripheral edema and increase in the size of cardiac dullness.Changes to the parameters of a blood test are not only in the increase of eosinophilic blood cells, but also expressed the degree of anemia.
clinical symptom eosinophilia parasitic origin is wider and the fore symptoms of intoxication syndrome in the form of lack of appetite, nausea, febrile fever, dizziness, and severe weakness.A typical manifestation of eosinophilia in this case is the appearance of muscle pain and arthralgia.An objective examination of the patient's attention is drawn to a significant hepatosplenomegaly and generalized lymphadenopathy, is not only in the formation of conglomerates, enlarged lymph nodes of various localization, but the soreness in their palpation.
appearance of a patient with eosinophilia common type of urticaria rash, accompanied by intense itching and the formation of ulcers, evidence in favor of the allergic nature of the disease.
presence of a patient suffering from gastrointestinal disease, signs of dysbiosis in the form of nausea and frequent vomiting episodes, varying degrees of frustration of a chair and seizures, shall suggest the appearance of eosinophilia.
Separation eosinophilia clinical types and forms necessary to determine the tactics and treatment of the patient.The basis of this classification laid Etiopatogenetichesky principle, it is a form of eosinophilia determined the cause of its appearance or localization of its manifestations.
So, eosinophilia, allergic nature arises from the release of high concentrations of histamine and eosinophilic chemotaxic factor mast cells and enhanced eosinophil migration of cells in the epicenter of an allergic reaction.The mechanism of activation of cytotoxic eosinophil function is triggered by the presence of foreign organisms on the surface of the mucosa.The main diagnostic method in this situation is to conduct a smear on nasal eosinophilia.Increasing the percentage of eosinophilic cells in the smear is an absolute diagnostic criterion allergic eosinophilia.
eosinophilia autoimmune origin or eosinophilic syndrome is diagnosed, the establishment of which is only possible by eliminating all possible allergic diseases.For the diagnosis of "eosinophilic syndrome" have to be the presence of a specific clinical and laboratory signs and no symptoms of an allergic nature.Laboratory signs of a long progressive eosinophilia more than 1,5 × 109 / L, and anemia.
clinical criteria autoimmune eosinophilia is the appearance of hepatosplenomegaly, organic heart murmur, congestive heart failure, diffuse and focal symptoms of brain lesions, weight loss and febrile syndrome.This form of eosinophilia longer occurs in young adults and is considered to be extremely unfavorable in relation to the treatment.In childhood eosinophilic syndrome manifests itself in the form of an isolated lesion of any organ, the heart is the primary localization.
eosinophils observed in limited inflammatory processes in various structures and tissues occurs with some features.So, eosinophilic myositis is a tumor volume, which has a clear localization in a particular group of muscles, mainly affecting the muscle fibers of the lower extremities.Muscle pain is accompanied by fever syndrome and persistent disorder of health.
Eosinophilic fasciitis is similar to the clinical manifestations of scleroderma, mainly affecting the face and skin, but in contrast to the pathology of scleroderma is characterized by rapid progressive course and responds well to hormone therapy.In this form of eosinophilia eosinophilic cell detection is possible not only in the peripheral blood and in the skin.
Eosinophilic gastroenteritis is a poorly understood pathology, as it is quite complicated to diagnose and has no specific clinical manifestations that distinguishes it from other diseases with damage to the intestine.Patognomonicheskim only symptom of this form of eosinophilia is the detection of Charcot-Leyden crystals in the faeces of patients.
Eosinophilic cystitis is a pathology of autoimmune nature, and is classified as "diagnosis of exclusion" that is, to establish it is only possible when there is no long-term effect of the treatment and it is impossible to determine etiopathogenetic factor of its origin.Increased number of eosinophil cells in circulating blood is combined with the accumulation of eosinophils in the mucosa of the bladder wall.
eosinophilia in cancer is a common manifestation and is most often observed in tumor lesions of the digestive tract and organs of the lymphatic system.Eosinophil cells in this form of the disease found not only in blood, but in the tumor substrate.The presence or absence of eosinophilia in a patient with oncopathology no significant effect on the prognosis of the underlying disease.
eosinophilia parasitic origin differs high levels of eosinophils in the blood, is more than 3 × 109 / L.In connection with similar clinical symptoms of this form of eosinophilia with eosinophilic syndrome for diagnostic purposes the patient must perform a number of microbiological research.In some cases parasitic infestation localization easily determine even visually, since lesion spot produced local inflammation in the pathogenesis of which plays an important role cytotoxic eosinophil function.Thus, the clinical symptoms of this form of eosinophilia is formed as the immediate symptoms of helminthic infestation, and general intoxication syndrome, caused by the action of eosinophils.
pulmonary eosinophilia is considered to be rare and the most difficult in terms of diagnostic pathology.This form of eosinophilia combines several pathologies that are significantly different clinical course of the disease, but having a single location that is predominant involvement of the lung parenchyma.The most specific form of pulmonary eosinophilia, Loffler's syndrome is considered, in which there is not only increasing the number of eosinophil cells in circulating blood, but also the appearance of eosinophilic infiltrative changes in lung having a volatile character.This pathology is not accompanied by severe respiratory disorders and is classified as accidental finds in preventive ray examination of patients.Due to the fact that the syndrome Leffler has no significant effect on the health disorder, specific treatment of this disease does not exist, and only in severe cases, apply a short course of corticosteroid therapy.
eosinophilia in asthma is observed only in the case of long-term course of the disease and is characterized by the development of a typical chronic eosinophilic pneumonia.This pathology is more common among patients and female accompanied by a progressive increase in the number and focal infiltrative changes in lung associated with moderate-marked eosinophilia in peripheral blood.
Eosinophilia in children
eosinophilia in childhood is not uncommon, as in this period the people most susceptible to allergic agents and parasitic infections.A feature of eosinophilia in children is its stability and the lack of correlation between the severity of clinical symptoms and the degree of increase in the number of eosinophilic blood cells.
in 80% of episodes of eosinophilia in children with additional inspection child shows signs of helminthic infestation caused by protozoa.The most stable and high eosinophilia provokes toxocariasis during migration of the larvae of the parasite.This pathology is not only visceral manifestations of hepatosplenomegaly, infiltrative changes in the lungs, but also the defeat of the skin, manifesting the appearance of creeping rash with severe itching.In a laboratory study, in addition to the severe degree of eosinophilia can be detected and gipoglobulinemiyu anemic syndrome.The first visual signs of helminthic infestation in children is pronounced itching in the crotch area, local hyperemia of perianal and sleep at night.
separate group of patients with symptoms of eosinophilia are children suffering from hereditary diseases in the form of family histiocytosis serious neonatal immunodefitsitarnogo syndrome.Have the child of a violation of the digestive function of the intestine should always suggests a form of eosinophilic gastroenteritis, because this pathology requires specific treatment and monitoring of patients.
type Transient eosinophilia may be seen as a normal variant in children born prematurely, and these changes do not require medical correction.Sustained progression of eosinophilia suggests pronounced anabolic disorders and needs careful doobsledovanii child to identify its causes.Some intrauterine infection accompanied by signs of eosinophils observed immediately after birth.
During the introduction of the first weaning foods for most babies may experience symptoms of atopic allergic reaction in the form of dermatitis, accompanied by transient eosinophilia, disappears with skin manifestations after the elimination of allergic agent.
to determine the tactics and treatment of a patient having a laboratory signs of eosinophilia should thoroughly examine the patient and establish the root causes of this pathology of blood.In most cases, the use of therapy eosinophilia etiopathogenetic orientation has positive results and contribute to the speedy recovery of the patient.
fundamental importance in the diagnosis of the causes of eosinophilia has carefully collected history of the patient, including identification of the main complaints of the patient, conditions and time of their occurrence.It is sure to be considered a hereditary factor of occurrence of eosinophilia, as these forms of pathology in need of a specific correction and dynamic observation of the patient.
So, eosinophilia diagnosed allergic genesis does not require specific treatment and its treatment is to eliminate the allergic agent.In a situation where the allergen is not possible to establish, held nonspecific desensitizing therapy (Tsetrin 1 capsule 1 time per day) to the normalization of eosinophils in the blood circulation.
pulmonary eosinophilia form in most cases do not require the use of medical methods of treatment, but in severe disease with severe respiratory disorders is recommended to use a short course of corticosteroids to 6 days (prednisolone at a daily dose of 15 mg a day orally).In the presence of bronchospastic component expressed recommended the use of the method of administration of inhaled beta-agonists (Theophylline).This category of patients is not subject to hospitalization and dispensary observation needs to conduct routine X-ray examination.
When reliably established eosinophilia caused by worm infestation recommended the use of exchange antiparasitic therapy (single dose of mebendazole in a therapeutic dose of 100 mg).