MDJunction - People Helping People
 
Ask a Question
01/07/2010 11:09 PM

Eosinophils and AI - anything you might know

LittleMissMerrySunshine
LittleMissMerrySunshine  
Posts: 1811
Group Leader

Gail and I have both had GI problems with eosinophils. I had eosinthrophilic gastroenteritis in the hospital, and she has also had high counts.

What I do know about e.g. - it is rare, caused by either a parasitic infection or allergies. They ruled out parasites, and my latest GI doc thought it must be allergies, and it's typically celiac disease. But that was before my AI diagnosis, and I've tested negative on all celiac tests (although there can be false negatives). The endo told me eosinophils are markers of Addison's, but that is all I caught.

What do these have in common? Why does the eosinophil count go up for AI patients? E.G. is rare, Addison's is rare, so finding corresponding info is virtually impossible.

Thanks,

Cynthia

Reply

01/08/2010 02:26 PM
dollsie
dollsiePosts: 312
Member

Hi Cynthia,

Eosinophilia is a common finding in Addison's disease. In fact, it used to be one of the main parameters for diagnosis (can still be used for clinical diagnosis). I had very high levels in my blood prior to diagnosis, as well as in my skin during rash biopsies and GI tract (eosinophilic esophagitis). They resolved with steroid replacement and now it happens when I'm undertreated.

I've asked many doctors about this - allergists/immunologists, hematologists/oncologists, endocrinologists, GPs. They all say that it is an uncommon finding in the general population, but very common with Addison's. It should get better as your treatment continues.

One of cortisol's main jobs is to mediate inflammatory responses and immunity. Allergies are really just an overactive immune response. Usually with severe allergies, a person will have either a high eosinophil count, or a high IgE, or both. This happens with Addison's - kind of like being perpetually allergic.

Other hematologic things are common too: low total WBCs with high percentage of lymphocytes, low percentage of monocytes, high eosinophils; low total RBCs, low Na, high K, high Calcium, sometimes slightly low eGFR, high BUN...

Leigh


01/08/2010 03:30 PM
gwebb
gwebbPosts: 400
Member

thanks Leigh for your insight here. I'm probably not Addisnon's, but secondary, but do have the elevated eosinophils. I posted a reply to the other thread about my stim test results.

I astually have a high white blood cell count, and my white blood cell percentages are:- Neutrophils 60%; Lymphocytes 40%; Monocytes 4%; Eosinophils 5%; Basophils 1%. And both my potassium and salt levels are low normal and are declining. (Based on the blood test results within 1 month of each other.)

So yeah, the elevated eosinophils are intriguing to me. I have eczma coming back (arms, shins, knees, thighs) and they are leaving hyperpigmented scars, which is why I thought I was probably primary before the STIM test. Could it be dermatitus herpetiformis? Isn't that the Celiac rash?

So thanks again for your input. We do appreciate it.

Gail Smile


01/08/2010 04:22 PM
dollsie
dollsiePosts: 312
Member

Hi Gail,

Well, I guess it is possible to have SAI and allergies/eczema. It's also possible to have a combination of PAI/SAI (if they're autoimmune). Do you have other autoimmune problems? Sorry if you've mentioned that somewhere else already...have you been tested for infections? I would think that your response to the ACTH during your stim test must mean something...but I guess the proof's in the pudding, as they say!

Celiac can really complicate things with AI, I think. If it gets to the point of causing malabsorption, low potassium (as well as low protein and anemia) can happen. So I think that might explain why some people with PAI don't have the typical high K prior to diagnosis...just an opinion though. For me, my K didn't go up until things got pretty bad. Of course, with SAI it's possible to have dilutional electrolyte problems too...especially if ADH is affected.

Low K and Na together can happen when too many fluids are lost from the body - are you having diarrhea/vomiting or peeing a lot? Do you take any diuretics?

There are some good pics of dermatitis herpetiformis on google images...

And here's some info on cortisol and eosinophilis. The link to the full article is http://emedicine.medscape.com/article/765753-overview

Physiologic effects of glucocorticoids

Glucocorticoids are nonspecific cardiac stimulants that activate release of vasoactive substances. In the absence of corticosteroids, stress results in hypotension, shock, and death. Glucocorticoids act as follows to:

Stimulate gluconeogenesis and decrease cellular glucose use

Mobilize amino acids and fatty acids

Inhibit the effects of insulin

Give rise to ketone bodies in metabolism (ketogenesis)

Elevate RBC and platelet levels

Exhibit anti-inflammatory effects, including the following:

Maintenance of normal vascular response to vasoconstrictors

Opposition to increases in capillary permeability

Inhibition of interleukin-2 (IL-2) production by macrophages

Stimulation of polymorphonuclear neutrophil (PMN) leukocytosis

Reduction of adherence of macrophages to endothelium

Depletion of circulating eosinophils and lymphocytes

Reduction of circulating lymphocytes (primarily T cells)

If eosinophils are controlled by cortisol, I guess it's possible to have high numbers with PAI and SAI...

Hang in there!

Leigh


01/08/2010 04:49 PM
lorajoy
lorajoy  
Posts: 338
Member

Gail,

I hope your doctors are watching your sodium levels closely. My son's sodium plummeted when he had the flu and he ended up in the ICU. You can crash fast....Just be careful!

Also, it is interesting because my son's levels of lymphocytes, neutrophils and basophils are always low when he has blood work. They have never seemed concerned about those. I have never noticed the Eosonaphils before.

Landon had severe GI problems when he was younger. He finally had to have fundoplication surgery when hew was 5 - was one of the best things we did for him. He still is on prevacid, though.

Lora-Joy


01/08/2010 05:54 PM
gwebb
gwebbPosts: 400
Member

hmmm, thanks for your feedbacl Lora Joy and Leigh. I don't know if I have any other auto immune things going on, as they haven't been tested as of yet. My Dr is waiting to see what the Endo says before he orders anymore tests. Or, also waiting to see if the Endo orders anymore tests.

I've looked at some of the images with dermatitus herp. and mine doesn't look as bad as some of them, no bullous papules happening, but there where similarities to the darker scarring. OK, another thing for the dr.

I've been thinking about going back to dr as he said that if anything comes up, to go straight back to him. But I did go and see him after my 'over-heating' episode about two weeks ago, and he put it down to the low blood pressure. I haven't been back to him about the hypoglecemic turns, but I just may now. Cause then I can also talk to him about the dermatitis herp.

And yeah, I am peeing alot, with thirst of course, but no vomitting and diarrhea. But I've never been someone to suffer from either of these two, even both times when I was pregnant. I suffered no morning sickness whatsoever. But I do have low protein and anemia (low ferritin stores only). From what I can gather, if the adrenals aren't getting enough ACTH from the brain, over a long period of time, the aldosterone and cortisol levels plummet, so therefore you get all these weird and wonderful things happening. My blood is also very acidic too.

And Lora Joy, I don't think my Dr is watching my sodium levels, but I am. I use sea salt in my water once or twice a day. My hubby is aware of what is happening and he knows what to do if something happens and he needs to take me to the ER. The Australian Addison's Org has some wonderful info brochures to give to doctors and ER staff in case of a crisis.

Thanks again ladies.

Reply

Share this discussion with your friends:


Disclaimer: The information provided in MDJunction is not a replacement for medical diagnosis, treatment, or professional medical advice.
In case of EMERGENCY call 911 or 1.800.273.TALK (8255) to the National Suicide Prevention Lifeline. Read more.
Contact Us | About Us
Copyright (c) 2006-2014 MDJunction.com All Rights Reserved