Eosinophilic Disorders

Eosinophils are a type of white blood cell that fight parasites and react in allergies. Eosinophilic disorders are a group of conditions in which too many eosinophils collect in blood or tissues and cause problems — most often in the digestive tract, lungs, or skin.

Common Indian causes to think of first

• Parasitic infections — still common: roundworms, hookworms, strongyloides, filariasis, schistosoma. Raised eosinophils may be the only clue.
• Allergic disease — asthma, allergic rhinitis, eczema, drug allergy.
• Eosinophilic oesophagitis / gastroenteritis — an allergic-type response in the gut, causing difficulty swallowing, food getting stuck, chronic reflux, pain, vomiting or diarrhoea.
• Eosinophilic pneumonia / lung disease.
• Hypereosinophilic syndrome — rare; very high eosinophil counts with organ damage.
• Churg-Strauss (EGPA) — a vasculitis with asthma, sinusitis, and raised eosinophils.
• Some cancers — lymphomas, leukaemias, some solid tumours can raise eosinophils.

When to see a Health Expert

• Persistently high eosinophils on a complete blood count.
• Chronic unexplained cough, wheeze, gut symptoms, or rash.
• Difficulty swallowing, food sticking, frequent vomiting.
• Weight loss with digestive symptoms.
• Travel to or living in areas with parasitic exposure.

Diagnosis and treatment

Evaluation includes stool examination for parasites, imaging, allergy work-up, sometimes endoscopy with biopsy. Treatment depends on the cause — anti-parasite treatment, allergy control, dietary changes (in eosinophilic oesophagitis), inhaled or oral steroids, or specific immune therapies in severe cases. India's parasite load means unexplained eosinophilia is worth taking seriously and investigating.