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Eosinophils 

  • Author: Benjamin Daniel Liess, MD; Chief Editor: Eric B Staros, MD  more...
 
Updated: Mar 28, 2014
 

Reference Range

The serum reference ranges of eosinophils are as follows:[1]

  • Eosinophils blood (%): 0.0-6.0 (This range may vary slightly in different laboratories.)
  • Eosinophil blood count (absolute): 30-350. The percentage of eosinophils is multiplied by the white blood cell count to give the absolute eosinophil count. This range may vary slightly in different laboratories.
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Interpretation

Increased eosinophil count (eosinophilia) may occur in many disease states, including but not limited to the following conditions:

  • Allergies
  • Dermatologic disorders
  • Parasitic infections
  • Bacterial infections
  • Myeloproliferative disorders and other malignancies
  • Collagen-vascular diseases
  • Side effects of medications

Eosinophil-associated diseases occur in all epithelial organs, including the gastrointestinal tract, urinary tract, upper and lower respiratory tracts, the skin, and the heart.

An absolute eosinophil count greater than or equal to 5x109/L indicates hypereosinophilia.

Esophageal biopsy demonstrating more than 20 epithelial eosinophils per high-power field indicates eosinophilic esophagitis.

Eosinophilic vasculitis is indicated by angiocentric eosinophil major basic protein (eMBP) staining.

Skin biopsy demonstrating few to many intact eosinophils indicates eosinophil-associated skin disease. Biopsy staining typically reveals extracellular eMBP, often out of proportion to the numbers of intact eosinophils.

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Collection and Panels

See the list below:

  • Specimen: Blood
  • Container: Lavender (EDTA) or pink (K 2 EDTA) and unstained whole blood smears.
  • Collection method: Venipuncture

Laboratory tests for nasal, nasopharyngeal, sputum, and tissue specimens are also available. Discuss collection methods and requirements with your laboratory prior to collecting the specimen.

Panels

Eosinophil count is typically part of the following panels:

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Background

Description

Eosinophils are white blood cells that play a role in fighting parasitic, viral, and bacterial infections. They also have a role in many other disease states (see Interpretation). Of note, however, patients without eosinophils, in the case of immunodeficiency or as a result of immunoglobulin G–mediated eosinophil precursor destruction, do not demonstrate any significant abnormalities related to low or absent eosinophil levels.[2] This is notedly distinct from a deficiency of other cell lines. Additionally, this finding should be tempered by assumption, as limited case reports are available to substantiate this claim. Eosinophil-deficient eosinophils were named such because they are “acid loving” and stain positive for coal tar dyes and turn red after staining with a red dye (the Romanowsky method).

The intracellular granules contain many mediators that concentrate the stain. During cellular activation, these granules are released, resulting in toxicity to the infectious organism and/or surrounding tissue. Eosinophils may be naturally found in the thymus, gastrointestinal tract, spleen, lymph nodes, ovaries, and uterus.[3] They are not normally found in the skin, lungs, or esophagus. Their presence in these locations may result in serious inflammatory conditions, organ injury, and disease states (see Interpretation).[4, 5]

Indications/applications

The eosinophil count should be taken into consideration when determining the possible role and/or manifestation of eosinophils in the infectious or inflammatory states as follows[5] :

  • Allergies
  • Dermatologic disorders
  • Parasitic infections
  • Bacterial infections
  • Myeloproliferative disorders and other malignancies
  • Collagen-vascular diseases
  • Side effects of medications
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Contributor Information and Disclosures
Author

Benjamin Daniel Liess, MD Assistant Professor, Department of Otolaryngology, University of Missouri-Columbia School of Medicine

Benjamin Daniel Liess, MD is a member of the following medical societies: American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, The Triological Society, American Medical Association, Missouri State Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Eric B Staros, MD Associate Professor of Pathology, St Louis University School of Medicine; Director of Clinical Laboratories, Director of Cytopathology, Department of Pathology, St Louis University Hospital

Eric B Staros, MD is a member of the following medical societies: American Medical Association, American Society for Clinical Pathology, College of American Pathologists, Association for Molecular Pathology

Disclosure: Nothing to disclose.

References
  1. Young, Barbara; Lowe, Joseph O'Connell; Stevens, Alan; Heath, John W. (2006). Wheater's Functional Histology. (5 ed.). Elsevier Limited:

  2. Gleich GJ, Klion AD, Lee JJ, Weller PF. The consequences of not having eosinophils. Allergy. 2013 Jul. 68(7):829-35. [Medline]. [Full Text].

  3. Rothenberg M, Hogan S (2006). The eosinophil". Annu Rev Immunol. 24 (1): 147–74.:

  4. Hogan S, Rosenberg H, Moqbel R, Phipps S, Foster PS, Lacy P, Kay AB, Rothenberg ME (2008). "Eosinophils: Biological Properties and Role in Health and Disease". Clin Exp Allergy. (5): 709–50.:

  5. Helbig G. Advances in the diagnosis and treatment of eosinophilia. Curr Opin Hematol. 2014 Jan. 21(1):3-7. [Medline].

  6. Hoffman R, Benz Jr. EJ, Shattil SJ, et al., eds. Hematology: Basic Principles and Practice. 4th ed. Philadelphia, Pa: Churchill Livingston; 2005:768:

  7. McPherson RA and Pincus MR. Henry's Clinical Diagnosis and Management by Laboratory Methods. 21st ed. Philadelphia, Pa: WB Saunders; 2007:474:

 
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