Eosinophils are elevated in a child: we are looking for the cause. Eosinophils are elevated in the child's blood

Eosinophils are a type of leukocyte that perform a protective function. An increased level of eosinophils in the blood of a child may be temporary or indicate the presence of diseases. Most often this is an allergy or helminthic infestation. Recurrent eosinophilia is a reason for a complete examination of the child.

What are eosinophils and their importance in the body

This protective function is performed by blood leukocytes, or white blood cells. There are several types of them, and each type has its own “specialization” and its own special structure.

Eosinophils make up 1-5% of the total number of leukocytes, they belong to segmented leukocytes because their nucleus has 2 segments, the cytoplasm contains granules with enzymes. They got their name from their ability to be stained during laboratory analysis with the acidic dye eosin.

The function of eosinophils is to neutralize:

In addition, eosinophils have the function of phagocytosis - capturing and neutralizing small foreign particles and microorganisms. They are able to exit the bloodstream through the vessel wall and go to the site of damage or inflammation.

Normal in children

The content of eosinophils in children is always higher than in adults. The reason for this is the child’s still imperfect immune system and greater susceptibility to diseases under the influence of various factors. Against the background of a lack of antibodies, more leukocytes are produced, including eosinophils. The table shows the permissible content of eosinophils depending on the age of the child:

Average daily values are presented because the content of eosinophils fluctuates throughout the day: in the morning it is minimal, 20% lower than the daily average, and at night it is maximum – 30% higher.

Increased eosinophils in a child

When pathogenic factors enter the body and eosinophils respond, the immune system sends a signal to the hematopoietic organs, and their production increases. This phenomenon is called eosinophilia, its causes can be both external and internal.

External reasons

Internal reasons

These include various pathological conditions of the body, for example, magnesium deficiency, tumors, blood diseases, disorders of the endocrine and digestive systems. Eosinophilia can also be hereditary and congenital, appearing in the prenatal period as a result of exposure to an infectious or allergenic factor on the fetus.

You can read about the increased content of eosinophils in the blood in adults.

Causes of severe eosinophilia in children

A fairly common occurrence in children is severe, or reactive, eosinophilia, which develops very quickly. As a rule, this is a blood reaction to an allergen. When an allergen enters, antibodies (special globulin proteins) are directed to it; they form complexes, binding to the antigen (allergen), inflammation and tissue swelling develop.

This is accompanied by the release of large amounts of histamine due to tissue damage. Histamine itself is a tissue toxin; eosinophils are sent to these areas for neutralization.

A sharp rise in the level of eosinophils up to 15-20% is observed in allergic pathology(diathesis, urticaria, bronchial asthma, allergic dermatitis, neurodermatitis, Quincke's edema). Also, a sharp increase in indicators is observed in such acute diseases as scarlet fever, pneumonia, septic endocarditis, meningitis, vasculitis (inflammation of blood vessels), hepatitis, tuberculosis, rheumatism, and infectious polyarthritis.

Major eosinophilia in children

When eosinophil levels exceed 20%, the condition is called major eosinophilia. Greater eosinophilia develops in severe acute infections and is also accompanied by an increase in the number of monocytes and the total number of leukocytes.

One of the forms is infectious eosinophilosis, the nature of which is still unknown. It manifests itself with high fever, runny nose, headache, and joint damage. In this case, eosinophils can rise to 50%.

Effect of drugs on eosinophils in children

Eosinophils always react to anything foreign that enters the body, and all medications are like that. Depending on their chemical composition, different medications have different effects on the blood, some are more likely to cause allergic reactions, others are more likely to cause toxic effects.

In any case, eosinophils do not remain indifferent; they constantly protect the body from any “encroachment” from the outside, and their number is increasing. There is a list of drugs to which the eosinophilic reaction is most pronounced in children, these include:

Antibiotics (tetracycline, erythromycin, penicillin group);
Anti-tuberculosis drugs (aminosalicylic acid);
Non-steroidal anti-inflammatory drugs;
Anticonvulsants (carbamazepine);
Psychotropic drugs (phenothiazine);
Antihypertensive drugs (methyldopa).

Diagnosis of eosinophilia

It should be remembered that a one-time increase in blood eosinophils in a child is not yet a basis for making a diagnosis. It may be a temporary reaction to certain foods (citrus fruits, for example).

Repeated tests are needed, and if eosinophilia recurs, the child is prescribed an examination: a complete blood count, biochemical tests (liver, kidney tests, proteins and electrolytes), an immunogram, a urine test, and a stool test for the presence of helminths.

How to normalize the number of eosinophils

What to do if a child has eosinophilia periodically or is it constant? How to bring eosinophils back to normal? We must remember that there is no cure for eosinophilia; it is not a diagnosis, but only a symptom that is a consequence of the disease.

Eosinophilia does not exist without a reason; it often signals the development of serious diseases– asthma, tumors, leukemia, rheumatoid arthritis and other pathologies. And if the diagnosis is not established, it means that the child has not been further examined.

You need to find an opportunity - a good clinic, a specialist - to establish a diagnosis and treat the underlying disease, adjust your diet according to the doctor’s recommendations. Then the level of eosinophils will return to normal.

Now you know the reasons why eosinophils are elevated in a child’s blood and what this means in diagnosing diseases.

Eosinophils are a type of white blood cell called leukocytes. They are synthesized in the bone marrow and mature in peripheral lymph nodes. Eosinophils absorb foreign proteins that enter the body of their host from the external environment. In accordance with their function, they live in those organs that come into contact with the external environment: the respiratory tract, lungs, stomach, intestines and skin. The main task of eosinophilic cells is to neutralize microorganisms or some foreign compounds, provoking a cascade of inflammation.

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What are eosinophils?

All human blood cells are divided into populations of red blood cells, white blood cells and platelets. The leukocyte lineage cell family, in turn, is divided into five cell groups:

neutrophils;
basophils;
eosinophils;
lymphocytes;
monocytes.

Each type of cell has a specific function and is named based on their characteristics and how they appear on a smear.

Eosinophils get their name from the way they perceive eosin, a standard dye used to treat blood for testing.

Under a microscope, these blood cells appear pink due to the granules contained in their cytoplasm.

Functions

This type of leukocyte performs several functions:

If the indicator is normal

The normal level of eosinophils in a clinical blood test is approximately 1-5% of the total number of leukocyte cells.

It can be determined either by “manual counting” when looking through a microscope, or using a special device - a hematology analyzer. The absolute number of eosinophils in 1 ml of blood is counted very rarely, but their normal number when decoding a CBC (complete blood count) is on average 120-350.

Eosinophilia - increased eosinophils in an adult

Reasons and types of increase

An increase in the level of eosinophils is considered significant when 700 or more cells are found in each milliliter of blood, that is, 2 or more times the upper limit of normal.

This condition is called eosinophilia.

There are three degrees:

light - more than 5%, but less than 10%;
average - from 10% to 15%;
pronounced (severe) - more than 15%.

The following processes can lead to eosinophilia:

Increasing quantity eosinophilic leukocytes in the blood does not always indicate pathology. The reason could be a simple error in calculations or staining, incorrect collection of a blood test, or other unforeseen situations. This is why a second control analysis is always required. It is important to remember that in the morning the level of eosinophil cells is 15% higher, and at night - 30%. For adequate results of a clinical blood test you need:

donate blood only in the early morning and on an empty stomach;
do not drink alcohol or overeat sweets 48 hours before taking blood;
donate blood from a vein, because when the fingertip is massaged by a nurse to improve blood flow, the cellular elements are injured and look completely different in the smear than normal;
contact trusted government clinics and commercial laboratories.

In children, eosinophils are elevated in various pathologies. The age of the child plays an important role in differential diagnosis. Depending on the month and year of the baby’s life, the causes of the phenomenon may be:

0-6 months	6 months-3 years	from 3 years
Hemolytic disease of the newborn	Atopic dermatitis	Helminthic infestations (pinworms)
Rhesus conflict between mother and fetus	Drug allergies	Food allergies
Pemphigus of newborns, atopic dermatitis and other skin pathologies	Food allergies	Allergic rhinitis
Staphylococcal or fungal infection	Quincke's edema	Bronchial asthma
	Malignant neoplasms	Scarlet fever
Serum sickness	Diffuse connective tissue diseases	Chicken pox
Eosinophilic colitis	Worm infestations	Malignant neoplasms

The main method of laboratory testing in children is a general blood test. With its help, pediatricians are able to diagnose various pathologies of the child’s body and promptly respond to the possibility of developing a serious illness.

One of the diagnostic components of a blood test is considered to be the leukocyte formula, which gives clinicians an idea of the processes of hematopoiesis and the reaction of the child’s body to external aggression. The leukocyte formula includes so-called white blood cells. These include eosinophils.

Eosinophils are one of the types of leukocytes and are responsible in the child’s body for counteracting foreign microorganisms, proteins and viruses. These blood cells are produced by human bone marrow, have a pale pink color and travel with the bloodstream through the vessels for 6–12 hours. After this short journey, they settle in the tissues of various organs and perform their protective functions for two weeks.

Reasons for increased eosinophil levels in a child

The growth of eosinophils in the blood of a boy or girl is called eosinophilia in the medical lexicon. The level of growth of these pale pink blood cells directly depends on the amount of harmful and foreign particles entering the child's body.

In fairly rare cases, it is possible to increase the level of eosinophils in the blood to 40–50% of the initial values. In this case, pediatricians raise the question of a serious blood cancer.

So, the main reason for the increase in the level of eosinophils in children can be considered the entry of various foreign proteins, viruses and bacteria into the bloodstream through the gastrointestinal tract, lungs and various scratches and the resistance of all white blood cells, mainly eosinophils, to this aggression. However, various chronic and hereditary diseases of the child’s body can lead to this pathology.

The range of causes of eosinophilia in a child is quite wide. First of all, these are various diseases of the respiratory system, accompanied by allergic reactions. Chronic bronchitis with an asthmatic component is already a complex pathology; the growth of eosinophils in it characterizes the severe course of the disease. One of the manifestations of a disturbed allergic background in children is the development of Quincke's edema, the symptoms of which are manifested by swelling of the oral mucosa, larynx and vocal cords, which in the absence of specialized help can lead to the development of hypoxia and even death.

Various skin diseases of an immune and allergic nature also occur with disturbances in the leukocyte blood count in the form of an increase in eosinophils. Various diathesis, eczema and viral dermatitis occur in a child as an allergic reaction to an external aggressive factor. Treatment is long-term and does not always lead to complete recovery.

When diagnosing an increase in eosinophils, do not forget about the possible entry of a staphylococcal infection into the child’s tissues. There is no need to expect any special pathological manifestations from it, since, given the pollution of the environment, the human body has long developed a protective reaction to it, but this infection will definitely cause an increase in white blood cells in the blood.

Formula-fed infants may develop eosinophilia when fed cow's and goat's milk, as well as various other components of baby food.

A similar reaction can occur when a child undergoes drug therapy for a variety of reasons. Most often, an increase in white blood cells is observed with the use of aspirin, metronidazole, and furosalidone.

One cannot discount the possible hereditary characteristic of reacting more vividly to external aggression than other children. In this case, an increased background of eosinophils may be a normal variant.

If you receive a test with an increased content of eosinophils in the child’s blood, it is necessary to conduct a repeat laboratory examination. Since the level of eosinophils is influenced by various factors, including the child’s excessive playfulness on the eve of the examination, there is no need to worry ahead of time. If the pathology is re-identified, the pediatrician will prescribe additional research methods for your baby to specify the cause of the disease.

The body of a small person is quite labile, and even if a child is diagnosed with a certain disease, timely and high-quality treatment will help cope with the problems much easier than in an adult. Normalization of leukocyte counts in children occurs much faster and requires less effort from doctors. There is only one recommendation for parents - to regularly undergo preventive examinations with a doctor with their child. This will help to avoid neglect of the pathological process, and as a result, long-term treatment.

Very often, when conducting a detailed clinical blood test, attention is drawn to changes in the number of leukocytes. By examining the leukogram in more detail, an experienced specialist may suspect a particular pathology. And what do elevated eosinophils in a child’s blood indicate? This is a question often asked by parents at an appointment with a pediatrician. To understand this, it is necessary to consider in more detail the morphological and functional features of these cells.

STRUCTURE AND FUNCTIONS OF EOSINOPHILES

Eosinophils are a subtype of leukocytes. They got their name because of their coloring. These cells are only able to absorb eosin, an intensely pink chemical. Unlike other types of leukocytes, eosinophils are not stained with basic dyes.

Eosinophils spend most of their life cycle outside the vascular bed. They leave it and go to damaged tissues. An increase in eosinophils in a child indicates that the existing cells are not able to restrain the activity of the pathological process.

REASONS FOR INCREASE

The reasons for an increase in eosinophils in a child are most often allergic reactions, which can manifest themselves in the form of:

broncho-obstructive syndrome;
seasonal diseases;
hypersensitivity to certain medications;
dermatological pathology.

Detection of eosinophils above normal is typical for cancer. The cell level can change significantly in advanced stages of the tumor, especially when the pathology affects the regional lymphatic system and is accompanied by necrotic processes.

Relative eosinophilia is a symptom of immunodeficiency conditions and systemic connective tissue diseases, especially in adulthood.

STANDARDS

Indicators of the leukocyte formula depend on the age of the child and are calculated in relative values. The rate of eosinophils in infants is much higher than in older children, and can reach 7–8% of all leukocytes. Over time, the number of these cells decreases. If eosinophils 6 for a 4-year-old child are considered a physiological indicator, then for older adults the norm is 1-2 percent of the total number of white blood cells. If eosinophils are elevated in a child, then you should consult a doctor

It is worth remembering that the results of a clinical blood test are influenced by hormonal factors. Night activity of the adrenal cortex leads to an increase in the number of eosinophils by a third, which must be taken into account when conducting studies at this time of day.

CLINICAL PICTURE

With eosinophilia, the patient most often exhibits signs of allergic pathology, which can occur against the background of complete health:

hyperemia and swelling of the conjunctiva;
lacrimation and mucous discharge from the nose;
violation of nasal breathing;
bronchial obstruction;
skin rashes.

In a newborn with elevated eosinophils, pathological reflexes, general weakness, and anxiety may appear. Often such a child sucks sluggishly at the mother's breast, which leads to worsening weight gain.

The severity of eosinophilia is directly proportional to the activity of the pathological process in the body.

RULES FOR PASSING THE ANALYSIS

Specialists from both public and private laboratories are capable of calculating the leukocyte formula. For the analysis results to be reliable, general recommendations must be followed:

the interval between blood sampling and the last meal should be at least 12 hours;
do not take medications;
exclude physical activity;
Do not donate blood after X-ray diagnostic methods or physiotherapeutic procedures.

WHAT TO DO WITH EOSINOPHILIA

If a child has elevated eosinophils, then, first of all, it is necessary to identify the reasons. To do this, a specialist needs to carefully collect an anamnesis of life and disease, conduct a physical examination, and determine the scope of laboratory and instrumental diagnostic methods. If you have symptoms of an allergic reaction, it is important to eliminate contact with the allergen; if you suspect a helminthic infestation - perform appropriate stool examinations.

It is worth remembering that eosinophilia is not a disease, but a symptom. This means that a child may have tissue damage of varying severity, and only the vigilance of parents and the professionalism of a pediatrician can identify the pathological process at an early stage, which will facilitate therapy and improve the prognosis for the little patient.

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A high level of eosinophils in a child is a violation of the blood count, when the test results are increased by more than 8%, and which indicates infection with helminths or allergies. The highest values of eosinophils (EO, EOS) are found in hypereosinophilia, when the analysis values reach 80 – 90%.

Causes of eosinophilia in children

The most common causes of elevated eosinophils in children include:

allergy manifested by:
- atopic dermatitis;
- hay fever;
- bronchial asthma;
- hives;
- Quincke's edema;
- food intolerance;
- hypersensitivity to the administration of antibiotics, vaccines, serum;
helminthiasis - both as an independent cause of eosinophilia, and as a factor provoking an allergic reaction;
infectious diseases, including scarlet fever, chickenpox, influenza, ARVI, tuberculosis, etc.

Eosinophils increased to 8% - 25% most often mean an allergic reaction or an infectious disease.

Less commonly, eosinophils in a child are elevated in the blood due to:

autoimmune diseases - systemic lupus erythematosus, scleroderma, vasculitis, psoriasis;
immunodeficiency hereditary disorder - Wiskott-Aldrich syndrome, Omenn syndrome, familial histiocytosis;
hypothyroidism;
oncology;
magnesium deficiency.

Magnesium ions are necessary for protein synthesis, including immunoglobulins of all classes. The lack of this macronutrient negatively affects the state of humoral immunity.

Eosinophils are elevated in infants with Omenn syndrome, an inherited genetic disorder characterized by:

scaly peeling of the skin;
enlarged liver and spleen;
diarrhea;
elevated temperature.

The disease is diagnosed in infants immediately after birth. In the blood test, in addition to increased EOS, leukocytes and IgE content were increased.

Allergy

Elevated eosinophils serve as an indicator of acute or chronic allergic processes developing in the body. In Russia, allergies are the most common cause of increased eosinophils in the blood of a child.

In addition to elevated eosinophils, food allergies are characterized by leukopenia, a high level of IgE immunoglobulins in the child’s blood, and the presence of EO in mucus from the stool.

There is a relationship between the degree of eosinophilia and the severity of allergy symptoms:

when EO increases to 7-8% - slight redness of the skin, slight itching, enlargement of lymph nodes to the size of a “pea”, IgE 150 - 250 IU/l;
EO increased to 10% - severe skin itching, the appearance of cracks, crusts on the skin, marked enlargement of lymph nodes, IgE 250 - 500 IU/l;
EO more than 10% - constant itching that disturbs the child’s sleep, extensive skin lesions with deep cracks, enlargement of several lymph nodes to the size of a “bean”, IgE more than 500 IU/l.

Eosinophils are increased in hay fever - allergic inflammation of the mucous membranes of the nasal cavity, paranasal sinuses, nasopharynx, trachea, bronchi, and conjunctiva of the eyes. Hay fever is manifested by swelling of the mucous membranes, runny nose, sneezing, swelling of the eyelids, and nasal congestion.

An increased level of eosinophils in hay fever is found not only in the peripheral blood, but also in the mucous membranes in areas of inflammation.

Allergy to vaccination

An increase in eosinophilic granulocytes may occur in children as a result of an allergic reaction to vaccination. Sometimes diseases that have nothing to do with the administration of the vaccine are mistaken for signs of vaccination complications.

The fact that eosinophils are elevated in a child precisely because of the administration of the vaccine is indicated by the appearance of symptoms of complications no later than:

after 2 days for vaccinations ADS, DPT, ADS-S - vaccines against diphtheria, whooping cough, tetanus;
14 days after measles vaccination, symptoms of complications appear more often on the 5th day after vaccination;
3 weeks with mumps vaccination;
1 month after polio vaccination.

An immediate complication of vaccination is anaphylactic shock, accompanied by increased eosinophils, leukocytes, erythrocytes, and neutrophils. Anaphylactic shock due to vaccination develops in the first 15 minutes after administration of the drug and manifests itself in the child:

worry, anxiety;
frequent weak pulse;
shortness of breath;
pale skin.

Eosinophils in helminthiasis

A common cause of increased eosinophils in children is infection with worms. The presence of helminths in the child’s body is determined using tests:

feces - diagnostics, with the exception of roundworm and giardia, is not accurate, because it does not detect larvae, waste products, the method does not work if the source of infection is outside the digestive tract;
blood - general analysis, liver tests;
ELISA is an enzyme-linked immunosorbent assay that determines the presence of antibodies in the blood to certain types of helminths.

Types of helminthiasis

Toxocariasis can occur in children with symptoms of bronchitis and pneumonia. The patient's condition is characterized by cough, fever combined with intestinal upset.

Signs of toxocariasis are:

abdominal pain;
skin rashes;
enlargement of the liver and lymph nodes.

So, if at first eosinophils in a child’s blood are increased to 85%, and after 3 weeks they decrease to 8% - 10%, then this most likely means that he is infected with trematodes.

According to WHO, in different countries of the world, from 30 to 60% of children are infected with Giardia. Giardiasis is accompanied by atopic dermatitis, urticaria, and food allergies. The increase in eosinophils in giardiasis is persistent, but the increase in indicators is often insignificant and amounts to 8% - 10%, although there are cases with EO 17 - 20%.

Infectious diseases

With high eosinophils and elevated monocytes, helminthic infestations and infectious diseases of the intestines and respiratory tract occur. Changes in the leukocyte formula of the blood depend on the nature of the pathogen.

In infections caused by viruses and bacteria, eosinophil counts are lower than in helminthiasis. And the severity of the infection explains why eosinophils can be elevated in a child or remain unchanged with the same type of pathogen.

The level of EO changes differently depending on the severity of the disease when infected with the parainfluenza virus. Parainfluenza is an acute respiratory viral infection with symptoms:

temperature rises to 38 degrees;
severe runny nose;
dry cough

Children may develop laryngitis, tracheitis, and there is an increased risk of laryngeal stenosis, especially if the child is prone to allergic reactions.

Uncomplicated parainfluenza occurs without an increase in ESR, with a slight decrease in leukocytes. With parainfluenza complicated by pneumonia, eosinophils are increased in children to 6–8%. In the blood test, lymphocytes were elevated, ESR increased to 15 - 20 mm per hour.

Elevated eosinophils in a blood test are detected in tuberculosis and infectious mononucleosis. The level of eosinophils depends on the severity of tuberculosis. Severe tuberculosis occurs with normal eosinophils.

A slight increase in eosinophils, lymphocytes above normal and the absence of young neutrophils in the blood in tuberculosis means recovery, or this is considered a sign of a benign course of the disease.

But a sharp drop in EO levels in the blood or even a complete absence of eosinophilic leukocytes is an unfavorable sign. Such a violation indicates a severe course of tuberculosis.

Infants under one year of age and adolescents from 12 to 16 years of age are especially susceptible to tuberculosis. Treatment of tuberculosis, due to prolonged use of drugs, can cause drug allergies. The appearance of an allergy means that the child’s eosinophils in a blood test will be higher than normal, and this increase sometimes reaches 20–30%.

Autoimmune eosinophilia

Increased eosinophil counts in children caused by an autoimmune disorder are rare. With high EOS, a child may be diagnosed with an autoimmune disease:

rheumatoid arthritis;
eosinophilic gastroenteritis;
eosinophilic cystitis;
periarteritis nodosa;
eosinophilic heart disease;
eosinophilic fasciitis;
chronic hepatitis.

With eosinophilic fasciitis, EO is increased to 8% - 44%, ESR rises to 30 - 50 mm per hour, IgG levels are increased. Periarteritis nodosa, in addition to elevated eosinophils, is characterized by high platelets, neutrophils, low hemoglobin, and accelerated ESR.

Eosinophilic gastroenteritis is considered a disease of childhood. The peculiarity of this disease is that with elevated eosinophils in the blood, the child sometimes does not have allergic manifestations, which means that they try to treat him on their own and see a doctor late.

Signs of eosinophilic gastroenteritis in children include:

lack of appetite, weight loss;
abdominal pain;
watery diarrhea;
nausea, vomiting.

The disease can be caused by food intolerance, both allergic and non-allergic. Attempting to cure a child on your own using folk remedies will only do harm, as it will not eliminate the causes of the disease.

Eosinophilia in oncology

An increase in eosinophils is observed in malignant tumors:

nasopharynx;
bronchi;
stomach;
thyroid gland;
intestines.

Eosinophils are elevated in Hodgkin's disease, lymphoblastic, myeloblastic leukemia, Wilms tumor, acute eosinophilic leukemia, carcinomatosis.

In children, acute lymphoblastic leukemia occurs more often than other malignant diseases (up to 80% of cases). Boys usually get sick; the critical age ranges from 1 to 5 years. The cause of the disease is a mutation in the lymphocyte precursor cell.

At risk are children with Down syndrome, Fanconi anemia, congenital or acquired immunodeficiency conditions. In acute lymphoblastic leukemia, the blood test shows increased neutrophils, eosinophils, monocytes and ESR, and decreased lymphocytes, erythrocytes, and hemoglobin.

The child's lymph nodes become enlarged, starting with the cervical ones. The nodes do not fuse together and are painless, which is why they may not cause concern for either the child or the parents.

The prognosis of the disease in oncology depends to a large extent on the timeliness of contacting a pediatrician. Increased temperature for no apparent reason, fatigue, enlarged lymph nodes, child complaints of headaches, pain in the legs, blurred vision - these symptoms cannot be ignored. They should definitely be a reason to contact your local pediatrician and get examined.