Eosinophilia

Introduction A condition in which eosinophils in peripheral blood exceed the normal value (normally no more than 450 per microliter or less than 7% of the total number of white blood cells). Eosinophil description: The cytoplasm contains deep red large particles. The shape of the nucleus is similar to that of neutrophils, usually 2-3 leaves, accounting for about 4% of the total number of white blood cells, and eosinophils in the blood account for 2%-4% of the total number of white blood cells, ie, 100-350 cells/1. The number of eosinophils in the blood has obvious day and night cyclical fluctuations, the number of cells in the morning decreases, and the number of cells increases at midnight. This periodic change in the number of cells is related to the diurnal fluctuations in the amount of glucocorticoid released from the adrenal cortex. When the concentration of corticosteroids in the blood increases, the number of eosinophils decreases; and when the concentration of corticosteroids decreases, the number of cells increases. Eosinophils contain large, elliptical eosinophilic granules in the cytoplasm. Such white blood cells also have a phagocytic function.

Cause

1 Parasitic diseases such as aphids, hookworms and schistosomiasis.

2 allergic diseases such as bronchial asthma and urticaria.

3 skin diseases such as psoriasis, eczema and exfoliative dermatitis.

4 blood diseases and tumors, such as lymphoma, eosinophilic leukemia, chronic myeloid leukemia, metastatic cancer.

5 systemic lupus erythematosus and other autoimmune diseases.

6 certain pulmonary-derived eosinophilia.

7 certain drugs, such as cyanine, streptomycin, sulfonamides.

8 other, such as eosinophilic gastroenteritis and endocarditis and lymphogranuloma. In addition, there are unexplained eosinophilia syndrome, eosinophils above 1500 / microliter and lasted for more than half a year, accompanied by multiple organ infiltration, poor prognosis, often due to heart disease and death.

an examination

Related inspection

Blood examination of the total number of bone marrow nucleated cells

Clinical manifestations are diverse, may have fever, cough, chest pain, palpitations, shortness of breath, neuropsychiatric symptoms, itching, rash, liver and spleen and lymphadenopathy, extremity edema. The most serious are subendocardial thrombosis and fibrosis, chordae fibrosis, leading to atrioventricular valve regurgitation, and eventually progressive congestive heart failure. Echocardiographic probing can be used for diagnosis and monitoring. Embolism from the heart, diffuse encephalopathy, peripheral neuropathy, especially multiple mononeuritis, are the main manifestations of nervous system involvement. The skin, respiratory system and digestive system are also often affected, and the main organ involvement has a poor prognosis. Patients with angioedema, the heart is often not involved, and the prognosis is good.

1. Systemic symptoms: Frequent systemic symptoms include fatigue, weakness, myalgia, fever, rash, angioedema, etc.

2. Extrarenal symptoms: Symptoms of involvement of extrarenal organs.

(1) Cardiopulmonary involvement symptoms: difficulty breathing, congestive heart failure; cough, chest pain, difficulty breathing, etc. X-ray examination showed pleural effusion, and diffuse interstitial infiltration occurred in about 2/3 of the cases.

(2) 80% of patients had hepatosplenomegaly and 15% had abnormal liver function.

(3) 1/3 patients have neurological symptoms, including central and peripheral, such as confusion, hallucinations, mental disorders, ataxia, and unclear articulation. Further developed as mild hemiplegia or peripheral neuritis.

(4) 25% to 50% of patients have skin lesions, usually maculopapular rash and urticaria.

3. Symptoms of kidney damage: The presence of nephrotic syndrome may occur, although the incidence is very low, but it may be life-threatening.

Differential diagnosis

(1). Allergic diseases: bronchial asthma, drug allergy, urticaria, food allergy, angioedema, serum disease and other peripheral blood eosinophilia can reach more than 10%.

(2). Parasitic diseases: schistosomiasis, ascariasis, hookworm disease and other blood eosinophilia, often up to 10% or more. Some patients with parasitic infections have significantly increased eosinophils. The total number of inverted white blood cells is tens of thousands, and more than 90% are eosinophils, which are eosinophilic leukemia-like reactions.

(3). Skin diseases: such as eczema, exfoliative dermatitis, pemphigus, psoriasis and the like, the peripheral blood eosinophils are mildly moderately elevated.

(4). Hematological diseases: such as chronic myeloid leukemia, eosinophilic leukemia, lymphoma, multiple myeloma, eosinophilic granuloma, etc., peripheral blood eosinophils may be increased to varying degrees, and some may With naive eosinophilia.

(5). Some malignant tumors: Some epithelial tumors such as lung cancer can cause eosinophilia.

(6). Some infectious diseases: Eosinophils are mostly reduced in acute infectious diseases, but eosinophils can be caused by scarlet fever.

(7). Others: rheumatic diseases, hypoplasia of the pituitary gland, allergic interstitial nephritis, etc. are often accompanied by eosinophilia.

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