Raised Eosinophill Count : Clinical Significance. Dr Rajesh Swarnakar MD,DTCD,DNB,FCCP(USA) Consultant Pulmonologist &Director Getwell Hospital & Research Institute, NAGPUR.
Dr Rajesh Swarnakar
Consultant Pulmonologist &Director
Getwell Hospital & Research Institute, NAGPUR
-Two-lobed, polymorphonuclear leukocyte 12 to 15 um diameter- Created by IL-3, Il-5 and GM-CSF -Three granule types, largest made up of MBP (major basic protein)- Kills Parasites, tumor cells, -Circulates <18 hours- 100-400 x more in tissues than in blood
Eosinophil – our friend or foe ?
Raised Eosinophill Count:
Normal volunteers = < 1%
Eosinophils count: What’s Normal?
Mild 500 to 1500 cells/microL
Moderate 1500 to 5000 cells/microL
Severe >5000 cells/microL
Categories of Eosinophilia
Peripheral eosinophilia can be divided into categories of ,
or idiopathic eosinophilia
Usually occurs in the context of hematologic malignancies, such as acute leukemias or chronic myeloid disorders, when there is evidence of clonal expansion of eosinophils
Eosinophils can also be seen in Hodgkin's and non Hodgkin lymphoma and other metastatic cancers, but the associated eosinophils are not of a clonal nature in this situation
The most common cause for secondary eosinophilia :
is parasitic lung infection. Noninfectious causes of secondary eosinophilia include allergic disorders, medications, toxins, autoimmune diseases, and endocrine disorders such as Addison's disease.
Parasitic-induced eosinophilic pneumonias (including Loeffler’s syndrome) Drug-or toxin-induced eosinophilic pneumonias Tropical pulmonary eosinophilia Allergic bronchopulmonary mycosis.
Idiopathic acute eosinophilic pneumonia Chronic eosinophilic pneumonia Churg-Strauss syndrome (allergic granulomatosis and angiitis) Idiopathic hypereosinophilic syndrome
Other Lung Diseases Variably Associated with Eosinophilia:Asthma/allergy
Bronchocentric granulomatosis Bronchiolitis obliterans-organizing pneumonia Infections – Fungal (esp.Coccidioidomycosis, Aspergillus,Pneumocystis jirovecii) -Tuberculosis
Interstitial lung disease -Idiopathic pulmonary fibrosis -Collagen-vascular disease associated -Sarcoidosis -Eosinophilic granuloma (pulmonary histiocytosis X) Malignancy -Non–small-cell cancer of lung -Non-Hodgkin’s lymphoma -Myeloblastic leukemia Miscellaneous (e.g., lung transplantation, ulcerative colitis
Treatment of primary disease suffices to bring down raised eosinophil count.
Collagen pulmonary/blood eosinophillia :Vascular Disease
History & Physical Exam
Stool Ova & Parasite Exam
Pulmonary Function Tests
Pulmonary Involvement Only
Chest x-ray Normal
IgE < 1.000
Chest x-ray Abnormal
IgE > 2.000
> 20% Eosinophils
< 20% Eosinophils
Allergic Bronchopulmonary Aspergillosis
Blood Eosinophil Count
Interstitial Lung Disease
Acute Eosinophilic Pneumonia
Chronic Eosinophilic Pneumonia Simple Pulmonary Eosinophilia
ICONIC - 2014 pulmonary/blood eosinophillia :
International Conference on Insights and Management of COPD
1st -2nd February, 2014
Hotel Hyatt Regency, Pune, India
Dear friends and colleagues,
On behalf of the organising committee, it gives us immense pleasure to welcome you to the first international conference on COPD – ICONIC 2014, to be held on 1st and 2nd February, 2014 at “Hotel Hyatt Regency”, Pune.
The scientific programme will cover insights on the burden, pathophysiology, risk factors for COPD, advances in disease management and new directions for research in COPD, and a discussion on the much needed policy change in the management of COPD practices in India.
Come listen to some of the internationally acclaimed leaders in Respiratory Medicine from across the globe including Prof. P. J. Barnes, Prof. James Hogg, Dr. John Walsh, Dr. Robert A. Wise, Dr. Sonia Buist, Dr. John R. Balmes and others.
Once again we extend a cordial welcome to you all and look forward to your active participation in ICONIC – 2014!!!
ICONIC is Endorsed by:
Organized by: Chest Research Foundation, India and Johns Hopkins University, USA
Organizing committee office:
Chest Research Foundation, Kalyani Nagar, Pune 411014, INDIA
Secretariat contact: Telephone (Contact): +91 22 2494 0518 Fax: +91 22 2494 0517
Email: [email protected] Website: : www.iconic2014.com