Eosinophilia

[lifeisafarce]

I recently have found out that I have eosinophilia. I have asthma, but my symptoms are stomach pain. I've read that if asthma is the cause, I would have wheezing and other breathing problems. But, if I have a parasite, then it would be stomach pain and other symptoms that I've experienced. They tested me for a parasite but it came back negative. I don't know too much about eosinophilia and my doctor didn't know too much about it either. Some of my questions are:
1) What are ways to treat this? My doctor suggested prednisone. I've taken that in the past.
2) Should we do testing to figure out what caused this?
3) What else should I know about eosinophilia?

Some background: I'm a 20-year-old mother of a 4-month-old baby. This problem started about 3 months ago. I am breastfeeding.

Thank you very much.

[Dr. Tamer Fouad]

lifeisafarce,
Eosinophilia is not a disease in itself; meaning, no one treats eosinophilia. Rather, one looks for a cause and then decides the treatment policy. Can you please send the details fo the tests you have mentioned. What parasitic infestation tests did you perform? Did you perform any other blood tests prior to this one? Did they also show eosinophilia?

I think in your case it appears that the asthma is causative factor here. Your medication (Albuterol) keeps the symptoms under control. The stomach problems are probably not related if your stool analysis came out negative for all possible infestations.

To know the possible infestations and other causes of eosinophilia check our oesinophilia page.

One question: During a previous visit to The Doctors Lounge you mentioned your stomach problems has that been resolved? Are you still taking Prilosec OTC, Tagamet (generic), Ranitadine emperically? Did you undergo and endoscopy?

[lifeisafarce]

Sorry, I forgot to mention what I've done. I've undergone an endoscopy. My doctor took a biopsy of my stomach lining, where she found out that I had eosinophilia. That's why I was wondering if asthma was the cause of my eosinophilia. A while ago, as in a 1.5 months or so ago, I did a stool test testing for parasites and that came back negative. I don't know what specific parasites they tested. My doctor only said that I had no parasites. I had blood taken several times. The first time, they noticed that I had high eosinophil levels (24%) but they passed it off as allergies. This was before I started taking all that medication. I'm no longer on prilosec, tagamet, ranitadine or sucralfate. Now, my doctor has me on Aciphex. And, it seems to be working. Most of the time anyway. It doesn't always work.

My stomach problem, according to my doctor, is due to eosinophilia. She can back this up with the biopsy from my stomach. I do have asthma, but if it asthma and parasites are not the cause, what could it be?

I've also been having lower abdominal discomfort and my doctor says that eosinophilia can affect the entire digestive system. She suggested that I get a colonoscopy in the near future if I'm still having problems.

[Dr. Tamer Fouad]

lifeisafarce,
Thanks for the update. It makes the whole situation very different now. I don't agree with the steroids. I think you need to be referred to a hematologist.
You need to exclude several serious diseases.

To diagnose Idiopathic hyperoesinophilic syndrome it is required that there be no other cause of the oesinophilia (such as asthma). However, this might be debateable since your problems seem to have risen due to a recent escallation in eosinophilia that does not seem related to your asthma.

Next, excluding chronic myelogenous leukemia, acute lymphocytic leukemia (ALL), acute myeloid leukemia (AML-M4EO), and myelodysplastic syndromes that manifest with significant eosinophilia is important. The presence of a Philadelphia chromosome or BCR/ABL suggests myelogenous leukemia. The presence of a t(5;14)(q31;q32) translocation indicates ALL with eosinophilia. The finding of inv(16)(p13q22) indicates AML-M4EO.

Finally, establishing clonality and the presence of chromosomal abnormalities consistent with eosinophilic leukemia is important in determining the diagnosis of this entity. Unfortunately, this can be difficult because most patients with CEL have normal karyotypes.

As you can see these disease entities require the consultation of an experienced hematologist. Please get back here to tell us the result of your doctor's visit.

Regards,