Increased level of eosinophils in the blood of a child. Eosinophils in a child are increased or decreased: blood standards, causes of deviations

Each cell of our body plays its role. Now we will talk about eosinophils.

Everyone knows that in our body there are erythrocytes (red blood cells) and leukocytes (white blood cells).

But few people know that leukocytes are also divided into:

• cells containing granules in the cytoplasm. These include basophils, neutrophils, eosinophils;
• cells that do not contain granules in the cytoplasm. Representatives of this group are monocytes and lymphocytes.

Thus, eosinophils are a type of leukocyte that contains granules. What kind of granules are these? These granules are found in the cytoplasm. Therefore, when staining cells, they are the ones that give eosinophils their bright red color.

In addition to the fact that eosinophils have specific granules, these cells are capable of producing various signaling molecules. They are called cytokines. They ensure the functioning of cytokines at the site of inflammation and participation in the activation of the immune system.

Place of synthesis

All blood cells mature in the bone marrow. There, from the universal precursor cell, eosinophil maturation occurs (Figure 1).

Fig.1. Scheme of eosinophil maturation.

A mature cell, a segmented eosinophil, enters the bloodstream. If young forms are detected in the blood, this may indicate excessive destruction of eosinophils or the receipt of a large number of signals in the bone marrow to stimulate the formation of these cells.

A signal came to the bone marrow about the need for the synthesis of eosinophils, and after 4 days these cells are waiting for their turn to enter the bloodstream.

Eosinophils circulate in the blood for only a few hours, after which they go into the tissues and stand guard over order. They remain in tissues for about 10–12 days.

A small number of eosinophils are found in tissues that border the environment, providing protection to our body.

It has already been said before what effects eosinophils can perform due to specific granules in the cytoplasm. But in order for eosinophils to be activated, that is, to release the contents of the granules, some kind of signal is required. Basically, this signal is the interaction of activators with receptors on the surface of eosinophils.

The activator can be antibodies of classes E and G, the complement system activated by helminth components. In addition to directly interacting with the surface of eosinophils, mast cells, for example, can produce chemotaxis factor, a compound that attracts eosinophils to that site.

Based on this, the functions of eosinophils include:

• participation in an allergic reaction. During an allergic reaction, histamine is released from basophils and mast cells, which determines the clinical symptoms of hypersensitivity. Eosinophils migrate to this area and promote the breakdown of histamine;
• toxic effect. This biological effect can manifest itself in relation to helminths, pathogenic agents, etc.;
• having phagocytic activity, capable of destroying pathological cells, but neutrophils have a higher ability;
• Due to the formation of reactive oxygen species, they exhibit their bactericidal effect.

The main thing to remember is that eosinophils are involved in allergic reactions and the fight against helminths.

The normal level of eosinophils in the blood of a child

As mentioned earlier, eosinophils do not stay in the bloodstream for a long time. Therefore, healthy children should not have many eosinophils.

The numerical values ​​of the norm depend on the method used to determine the number of cells. In old laboratories, the leukocyte formula is calculated manually, the result is given only in relative values, that is, in %.

Normally, in children under 4 years of age, the relative number of eosinophils should not exceed 7%. Over this age, the norm is the same as for adults - no more than 5%.

In modern laboratories, cells are most often counted automatically on a hematology analyzer, and only in exceptional cases are they counted manually. When counting cells on the analyzer, the result can be given in the form of relative and absolute values.

The absolute number of eosinophils reflects their exact number per liter of blood.

The absolute values ​​of normal eosinophils are presented in the table.

Table. The norm of eosinophils in the blood of children.

Data with normal values ​​are given for informational purposes only; you should not decipher the results of the analysis yourself!

Indications for determining the level of eosinophils in the blood

If your child is crying, then something is bothering him, but he cannot tell you about it. Therefore, it is extremely important to understand what is happening to it and prevent the development of serious complications.

In addition to food allergies, it is possible to develop hypersensitivity to dust, animal hair, pollen, and even medications.

How to take the test correctly?

In order for the analysis result to be accurate and truly reflect what is happening in our body, we need to be properly prepared. Moreover, there is nothing complicated in preparing for this analysis.

First of all, both parents and the child need to prepare mentally. It is best for the child not to cry, not to panic, and to behave calmly. To do this, parents should explain to the baby what will happen in the hospital, that there is nothing wrong with it. Maybe you can even promise your child something in return if he behaves well.

It is also important to prevent your child from running around the hospital corridors while waiting for their turn in the blood collection room. Physical activity may affect study results.

Also, one of the most important rules for preparing for a blood test is that it must be taken on an empty stomach. If the child is already big (over 4 years old), then you can be patient and donate blood after an overnight fast. It is allowed to give the child water to drink.

Blood is most often taken from the finger; in very small children, from the heel.

When preparing to donate blood, it is important to take prescribed medications. A number of medications can affect test results. Therefore, it is advisable to talk to your doctor about this. Don't do anything on your own!

Some medications can affect the level of the determined indicator. For example, Prednisolone can lead to a decrease in the level of eosinophils and monocytes in the blood.

If parents properly prepare for donating blood, they will not have to take the test again, plunging their child into a stressful situation.

Interpretation of results

The interpretation of the results should be carried out by the attending physician who referred your child for a blood test. If the parents independently asked for a blood test, then deciphering the answer should be entrusted to a specialist. It may be located in the same place where the blood was donated, or you can contact your place of residence with a ready-made test result.

When eosinophils are elevated in a child and in an adult, this condition is called eosinophilia. Next we will look at situations where this is possible and why it occurs.

Why are eosinophils in a child’s blood elevated?

There are a number of conditions when eosinophils are elevated in the blood.

If elevated levels of eosinophils are detected, parents should consult a doctor. Since this is a “bell” that something is going wrong in the child’s body.

If an allergic reaction is confirmed, it is important to identify its source. Then remove the child from contact with this allergen.

In general, in any case, consult a doctor, independence can aggravate the situation.

The situation when a child has elevated eosinophils occurs quite often. In most cases, this indicates health problems, but sometimes it can be a minor deviation. To understand this, it is important to study all the possible reasons for this phenomenon, as well as find out what indicators correspond to the norm.

What are eosinophils

Eosinophils are specific blood cells that are formed in the bone marrow. They belong to the group of leukocytes. This means that the main task of eosinophils is to protect the body from infections and other diseases.

A complete blood count sometimes reveals that a child has elevated eosinophils

Norms of eosinophils in children

To find out whether a child’s eosinophils are elevated or not, you need to know what the norm is. Its indicators vary depending on the age of the child. Since eosinophils are often recorded as a percentage, the figures for different age groups are as follows:

• from birth to two weeks - 1-6%;
• from two weeks of age to one year - 1-5%;
• 1-2 years - 1-7%;
• 2-4 years - 1-6%;
• 5-18 years old - 1-5%.

As can be seen, eosinophils may be present in the blood in small quantities. This is normal and does not require correction.

What does an elevated level of eosinophils indicate?

An increased level of eosinophils is indicated if a specific indicator exceeds the norm by more than 10%. This condition is called eosinophilia in medical circles.

It can be moderate or pronounced. The more eosinophils, the more acute the disease.

An increase in eosinophils can occur for various reasons. Unfortunately, not all are known to modern medicine. To date, several diseases that are accompanied by eosinophilia have been reliably identified:

• Worm infestation. We are talking about infection with pinworms, roundworms and other types of helminths.
• Allergy. Includes various kinds of skin reactions, bronchial asthma of an allergic nature, hay fever, serum sickness.
• Dermatological pathologies. This category includes various types of dermatitis, lichen, and eczema.
• Connective tissue diseases: vasculitis, rheumatism and other inflammatory processes.
• Some hematological diseases: lymphogranulomatosis, erythremia, etc.
• Infectious diseases.

In addition, there is the so-called hypereosinophilic syndrome. This term refers to a pathological condition that is accompanied by a persistent increase in eosinophils in the blood of a child or adult and lasts for at least six months. The etiology of this disease remains unclear, but the described condition poses a great danger to health. It causes damage to the brain, lungs and other internal organs.

Reasons for increased eosinophils in newborns

High levels of eosinophils are often observed in infants immediately after birth or in the first months of life. In such young children, such a pathology is associated with the fact that the body is struggling with some foreign protein. Most often, eosinophilia is caused by allergies. This is usually a reaction to formula or foods that a nursing mother eats.

Allergies can manifest themselves in the form of rash, eczema, and hives. Often such children are diagnosed with diathesis.

If eosinophils are elevated in an infant, this may indicate lactose intolerance. This diagnosis is accompanied by diarrhea, severe flatulence, and low weight. In this case, additional diagnostics need to be performed.

Eosinophils and other blood parameters

To diagnose a disease associated with an increase in eosinophils, it is necessary to take into account other test indicators. If monocytes are elevated with eosinophilia, this most likely indicates a viral infection, such as mononucleosis. To draw the appropriate conclusion, it is necessary to pay attention to the clinical signs of the disease: the presence of cough or rhinitis, sore throat, increased body temperature. In such a situation, there is a shift in other indicators - for example, lymphocytes are also increased.

Marked eosinophilia and high white blood cell counts may be a sign of impending scarlet fever. Also, such a combination suggests a helminth infestation or an allergy combined with an infectious disease.

Determination of eosinophil levels

To find out the level of eosinophils and other indicators in the child’s blood, it is necessary to take a blood test. This abbreviation refers to a general blood test.

The study can be carried out in a regular clinic, hospital or in a private laboratory. The only difference is that in a government agency you will need a referral from a doctor. For analysis, blood from young children is taken from a finger using a special instrument. This is a faster and less painful method than taking blood from a vein.

The level of eosinophils depends on many factors. For example, in the morning and in the first half of the day it is lower, and in the evening it can rise. That is why they take the test strictly on an empty stomach.

A high level of eosinophils in children of any age is a reason for parents to be wary and show increased interest in the health of their child. Depending on the severity of eosinophilia and the presence of associated symptoms, additional studies may be necessary. For questions regarding further diagnostics, you should consult a doctor. Self-medication in this case is unacceptable.

If a blood test shows that eosinophils are elevated in a child, then it is necessary to identify the reasons that caused this change. In this way, the baby’s body can react to many irritants: insect bites, vaccinations, allergens, helminthic infestation and bacterial or viral infection. Eosinophilia in children is not considered an independent pathology, but it can be a sign of the disease. To normalize the leukocyte formula, you should undergo an examination and remove the cause of the changes.

What are eosinophils

A type of white blood cell produced by the bone marrow is called eosinophils. The main location of these blood cells is in the respiratory organs of the chest (lungs, bronchi), intestines, stomach and capillaries. The main task of eosinophils is to destroy foreign aggressive agents that have penetrated the internal environment of the body. This is evidenced by the resulting inflammatory reaction with the release of cationic protein.

Main functions of eosinophils:

• absorption (phagocytosis) of histamine;
• release of an enzymatic protein that destroys the shell of dangerous agents;
• production of biologically active enzymes;
• participation in the production of plasminogen (an indicator of the anticoagulation system).

What do eosinophils show in a blood test?

As a rule, eosinophils are elevated in a child due to the active entry of foreign protein into the bloodstream. Changes in indicators occur in various pathological conditions. Eosinophils can indicate the following dangerous diseases:

1. infections (bacterial, viral or helminth infections);
2. allergies;
3. inflammation in organs and tissues;
4. cancerous formations;
5. pathologies of immunity.

Normal eosinophil count in children

The absolute number of eosinophil levels in older minors is equal to normal levels in adults. The digital value of the leukocyte formula is calculated in relative values, and The norm of eosinophils in the blood of children depends on the age of the child:

Elevated eosinophils in the blood of a child

To determine the number of these blood cells, doctors prescribe a general blood and urine test. If eosinophilic cationic protein is elevated in a child, then parents should undergo a full examination with the baby to identify a hidden disease. A high number of these white blood cells is called eosinophilia. It can be small - up to 15% of bodies, moderate - up to 20%, high - more than 20%. In severe situations, the deviation is up to 50% of the eosinophil content. In addition to an increase in this type of leukocytes, the analysis may show that monocytes are increased.

Clinical picture

If eosinophils are elevated in an infant or older child, then he will have a special clinical picture. With eosinophilia, signs of an allergic process appear against the background of the baby’s normal health:

• swelling of the mucous membrane of the eyes;
• hyperemia of the mucous surfaces of the nasopharynx and conjunctiva;
• allergic rhinitis;
• profuse lacrimation;
• nasal congestion;
• bronchospasm;
• skin rash.

In a newborn baby, high white blood cell counts are dangerous to health. They cause general weakness in the baby, lethargy, pathological reflexes, anxiety and poor sleep. Such a child slowly gains weight because he refuses to breastfeed and eats little. Experts note that the more actively the pathological process develops in the newborn’s body, the higher the severity of eosinophilia.

Causes

An increase in the number of leukocyte cells is caused by many reasons and pathologies developing in the baby’s body:

What to do with eosinophilia

There is no special treatment for eosinophilia, but the doctor must diagnose and treat the underlying disease. To do this, patients first take tests and undergo additional examinations, and then receive the necessary medications. Courses of treatment for common diseases that cause an increase in white blood cells may be as follows:

Prevention

If eosinophils were elevated in a child, then prevention of this condition should be done in the future. These measures will allow healthy people to avoid eosinophilia. To keep their baby healthy, parents should:

• organize the child’s daily routine and nutrition;
• lead a healthy lifestyle with children;
• regularly examine the baby and undergo the necessary treatment;
• ensure that the child observes the rules of personal hygiene.

Video

A change in the number of eosinophils in the results of a CBC indicates that there is an imbalance between the process of hematopoiesis in the bone marrow, the migration of blood cells and their breakdown in the tissues of the body.

Eosinophil function

Main functions of eosinophils:

• detect and collect information about foreign substances entering the body,
• transmit the received data to the immune system,
• neutralize foreign proteins.

Therefore, it is quite acceptable to increase eosinophils in the blood of children, because as they explore the world, they encounter a large number of agents that are new to them.

It should be remembered that the concentration of these cells depends on the time of day. At night their number increases, during the day it returns to normal.

Normal indicators and what causes an increase in eosinophils in children

• In newborns – 1-6
• In children under two weeks of age – 1-6
• From two weeks to one year – 1-5

• From one to two years – 1-7
• From two to five years – 1-6
• From six to sixteen years old – 1-5

If the indicators are higher, then this condition is called eosinophilia. It’s not very good when the analysis showed low eosinophils in the child’s blood. This may signal the initial stage of inflammation, a stressful condition, a purulent infection, or poisoning with any heavy metals or chemicals.

Role in the body

Functions of eosinophils

Locations of eosinophils: lungs, skin capillaries, gastrointestinal tract.

They fight foreign proteins by absorbing and dissolving them. Their main functions are:

• antihistamine;
• antitoxic;
• phagocytic.

The eosinophil rate is calculated by determining the level of cells as a percentage of the number of all white cells. The acceptable level of eosinophils in the blood varies depending on the child's age:

• in infants up to one month of age - no more than 6%;
• up to 12 months – no more than 5%;
• from one year to three years of age - no more than 7%;
• from three to six years – no more than 6%;
• from six to twelve years – no more than 5%.

In children over 12 years of age, the upper limit of eosinophils should not exceed 5% of the total number of leukocytes.

What are eosinophils

Deviations from norms

The most common causes of deviations from normal levels of eosinophils in the blood in children are allergies and worms. Allergies arise from the hair of pets, certain foods, and plant pollen.

An increase in the level of eosinophils can be provoked by Quincke's edema, exudative diathesis, urticaria, asthma, and neurodermatitis.

Eosinophil cells exceed the norm in the blood if the child has:

• rheumatism;
• scarlet fever;
• psoriasis;
• vasculitis;
• tuberculosis;
• pneumonia;
• hepatitis;
• heart defects.

Deviations from the norm occur after severe burns, surgery to remove the spleen, and also as a result of taking antibiotics and hormonal drugs. A genetic factor also often causes high levels of leukocyte eosinophils in the blood.

Eosinophil abnormalities

Eosinophilia

An excess of eosinophils in the blood is called eosinophilia. The following types of pathology are distinguished:

1. Reactive eosinophilia. The cell level is increased by no more than 15%.
2. Moderate eosinophilia. The excess of the norm from the number of all leukocytes is no more than 20%.
3. High eosinophilia. The number of eosinophilic leukocytes is more than 20%.

In case of serious pathologies, the excess of the norm can be 50% or more.

Eosinophilia has no characteristic symptoms; the clinical manifestations of the pathology depend on the disease that caused the changes in the blood. The child experiences elevated body temperature, heart failure, joint and muscle pain, weight loss, anemia, and skin rashes.

Rash due to eosinophilia

If a child’s tests reveal a large number of eosinophilic cells, you should contact your pediatrician. He will prescribe a urine test, scraping for worm eggs, and serological tests. If necessary, the doctor will refer the baby to an allergist and dermatologist.

Allergy is also accompanied by eosinophilia

Important! If, even after treatment, eosinophils are elevated, it is recommended to undergo examination to determine the level of immunoglobulin.

So, the main task of eosinophils is to neutralize pathogenic microorganisms and destroy histamine produced during allergies. A high level of eosinophils indicates the presence of diseases such as dermatitis, rubella, scarlet fever, asthma, and tuberculosis in the child’s body.

With proper diagnosis and treatment of the disease that caused the increase in the level of cells in the blood, their indicator will soon return to normal.

Eosinophils are a type of white blood cell that is constantly produced in the bone marrow. They mature over 3-4 days, after which they circulate in the blood for several hours and move to the tissues of the lungs, skin and gastrointestinal tract.

A change in the number of these cells is called a shift in the leukocyte formula, and may indicate a number of disorders in the body. Let's look at what eosinophils are in blood tests, why they can be higher or lower than normal, what diseases this shows and what it means for the body if they are elevated or lower.

The norms of such particles in the blood are determined by a general analysis and depend on the time of day, as well as the age of the patient. In the morning, evening and night, their number may increase due to changes in the functioning of the adrenal glands.

Due to the physiological characteristics of the body, the level of eosinophils in the blood of children may be higher than in adults.

A shift in the leukocyte formula with a high level of eosinophils (eosinophilia) indicates that an inflammatory process is occurring in the body.

Depending on the degree of increase in a given type of cell, eosinophilia can be mild (increase in number by no more than 10%), moderate (10-15%) and severe (more than 15%).

A severe degree is considered a rather dangerous condition for humans, since in this case there is often damage to internal organs due to oxygen starvation of tissues.

In itself, an increase in eosinophils in the blood cannot indicate damage to the heart or vascular system, but pathologies, the symptom of which is an increase in the number of this type of leukocytes, can cause cardiovascular diseases.

The fact is that in the place of their accumulation, inflammatory changes are formed over time, destroying cells and tissues. For example, long-term, severe allergic reactions and bronchial asthma can cause eosinophilic myocarditis, a rare myocardial disease that develops due to exposure to eosinophil proteins.

A decrease in the level of eosinophils in the patient’s blood (eosinopenia) is no less dangerous than their increase. It also indicates the presence of an infection, pathological process or tissue damage in the body, as a result of which protective cells rush to the source of danger and their number in the blood drops sharply.

The most common cause of a decrease in eosinophils in the blood in heart disease is the onset of acute myocardial infarction. On the first day, the number of eosinophils may decrease until they completely disappear, after which, as the heart muscle regenerates, the concentration begins to increase.

Low eosinophil counts are observed in the following cases:

• severe purulent infections and sepsis - in this case, the leukocyte form shifts towards the young forms of leukocytes;
• in the first stages of inflammatory processes and in pathologies requiring surgical intervention: pancreatitis, appendicitis, exacerbation of cholelithiasis;
• severe infectious and painful shocks, as a result of which blood cells stick together into mud-like formations that settle inside the vessels;
• dysfunction of the thyroid gland and adrenal glands;
• poisoning with lead, mercury, arsenic, copper and other heavy metals;
• chronic emotional stress;
• advanced stage of leukemia, when the concentration of eosinophils can drop to zero.

Eosinopenia

Situations where eosinophils are low are much less common than conditions with high eosinophils. The norm of eosinophils in children itself is quite low, and a drop in these indicators down to zero may not indicate anything serious. However, any deviation from the norm in children requires additional examinations. If eosinophils are low in a child, this is due to a general decrease in the number of leukocytes in the blood. Most often it happens:

• due to taking strong medications (antibiotics, anticancer drugs),
• due to severe poisoning,
• in comatose states,
• for diabetes mellitus and uremia,
• severe infectious diseases with clear clinical manifestations (for example, influenza) in the initial period give the concentration of the blood cells in question below normal,
• injuries, extensive burns,
• in premature infants whose condition is accompanied by sepsis,
• sometimes with Down syndrome.

It has been noted that with increased work of the adrenal glands and a number of other reasons that increase the level of corticosteroid hormones, the maturation of eosinophils is blocked and they cannot leave the bone marrow into the bloodstream.

Of course, there is no specific treatment aimed at normalizing the low level of eosinophils in the blood. With successful treatment of the underlying disease, the child’s eosinophil values ​​themselves level out to normal levels.

Causes of eosinophilia

Among the many blood cells, there is a population of white blood cells called eosinophils, which are markers that determine:

The cells got their name due to their ability to perfectly absorb the dye eosin, used in laboratory diagnostics.

Under a microscope, the cells look like small amoebas with a double nucleus, which are able to move beyond the vascular wall, penetrate the tissue and accumulate in inflammatory foci or areas of tissue damage. Eosinophils float in the blood for about an hour, after which they are transported to the tissues.

For adults, the normal content of eosinophils in a clinical blood test is considered to be from 1 to 5% of the total number of leukocytes. Eosinophils are determined by flow cytometry using a semiconductor laser, and the norm in women is the same as in men. More rare units of measurement are the number of cells in 1 ml of blood. Eosinophils should be from 120 to 350 per milliliter of blood.

The number of these cells can fluctuate during the day due to changes in the functioning of the adrenal glands.

• In the morning and evening hours, there are 15% more eosinophils compared to normal
• In the first half of the night 30% more.

For a more reliable analysis result, you should:

• Take a blood test in the early morning hours on an empty stomach.
• For two days you should abstain from alcohol and excessive consumption of sweets.
• Eosinophils may also increase during menstruation in women. From the moment of ovulation until the end of the cycle, their number decreases. The eosinophilic test of ovarian function and determination of the day of ovulation is based on this phenomenon. Estrogens increase the maturation of eosinophils, while progesterone decreases it.

As the child grows, the number of eosinophils in his blood fluctuates slightly, as can be seen from the table.

A significant increase in the number of eosinophils is considered to be a condition when there are more than 700 cells per milliliter (7 to 10 to 9 grams per liter). An increased content of eosinophils is called eosinophilia.

• Growth up to 10% - mild degree
• From 10 to 15% - moderate
• Over 15% (more than 1500 cells per milliliter) – pronounced or severe eosinophilia. In this case, changes in internal organs may be observed due to cellular and tissue oxygen starvation.

Sometimes errors occur when counting cells. Eosin stains not only eosinophilic granulocytes, but also granularity in neutrophils, then neutrophils are reduced and eosinophils are increased without good reason. In this case, a control blood test will be required.

• For allergic rhinitis, swabs are taken from the nose and throat for eosinophils.
• If bronchial asthma is suspected, spirometry and provocative tests (cold, with Berotec) are performed.
• The allergist then carries out specific diagnostics (determination of allergens using standard serums), clarifies the diagnosis and prescribes treatment (antihistamines, hormonal drugs, serums).

If the absolute number of eosinophils per milliliter of blood falls below 200, the condition is interpreted as eosinopenia.

Eosinophil counts become low in the following cases:

• In severe purulent infections, including sepsis, when the population of leukocytes shifts towards young forms (band and segmented), and then the leukocyte response is depleted.
• At the beginning of inflammatory processes, with surgical pathologies (appendicitis, pancreatitis, exacerbation of cholelithiasis).
• On the first day of myocardial infarction.
• In case of infectious, painful shock, when the formed elements of the blood stick together into mud-like formations inside the vessels.
• For poisoning with heavy metals (lead, copper, mercury, arsenic, bismuth, cadmium, thallium).
• For chronic stress.
• Against the background of pathologies of the thyroid gland and adrenal glands.
• In the advanced stage of leukemia, eosinophils drop to zero.

• Lymphocytes and eosinophils are elevated during viral infections in allergy sufferers, in patients with allergic dermatoses or helminthiases. The same picture will be in the blood of those who are treated with antibiotics or sulfonamides. In children, these cells increase in scarlet fever and the presence of the Epstein-Barr virus. For differential diagnosis, it is additionally recommended to donate blood for the level of immunoglobulins E, for antibodies to the Epstein-Barr virus and feces for worm eggs.
• Monocytes and eosinophils increase during infectious processes. The most typical case in children and adults is mononucleosis. A similar picture may occur with viral and fungal diseases, rickettsiosis, syphilis, tuberculosis, and sarcoidosis.

The leukocyte composition of the blood contains cells responsible for the body’s reaction to the penetration of foreign microorganisms or harmful substances into it. Therefore, if a child has elevated eosinophils, the doctor must identify the cause that caused this deviation.

Role in the body

Eosinophils are a type of granulocyte produced by the bone marrow to fight toxins, foreign microorganisms, or their breakdown products.

The cells got their name because of their ability to absorb the dye eosin, which determines the color of this type of blood cell. These cells are not stained with basic dyes in laboratory tests, like basophils.

From the bone marrow they are carried through the blood capillaries to the tissues of the body, mainly accumulating in the lungs and the gastrointestinal tract.

A blood test allows you to determine the absolute or relative number of a given type of leukocyte.

The norm of eosinophils in children in absolute terms should be:

• babies from birth to one year 0.05-0.4 Gg/l (Giga grams/liter),
• children from one to 6 years old 0.02-0.3 Gg/l,
• children over 6 years old and adults 0.02-0.5 Gg/l.

However, most often a laboratory analysis shows the number of eosinophils in a child’s blood in relation to other leukocytes, that is, a relative value.

Its norm in children of different ages should be within the following limits:

• children up to 2 weeks 1-6%,
• children under 1 year 1-5%,
• 1-2 years 1-7%,
• from 2 to 5 years 1-6%,
• 5-15 years 1-4%,
• over 15 years 0.5-5%.

The eosinophilic composition of the blood is greatly influenced by the time of blood sampling for testing and proper preparation for the test. An increase in eosinophils in the blood is observed at night, when the adrenal glands intensively produce hormones.

Therefore, generally accepted standards take into account the leukocyte composition of the blood for the average person who donated blood in the morning.

The level of eosinophils in the blood is also affected by the menstrual cycle in women. An increase in the amount of progesterone, which peaks at the time of ovulation, reduces the number of these cells. This property of the body made it possible to create a test to determine the day of ovulation, which is very important for women planning a pregnancy.

Deviations from norms

Unfortunately, the analysis does not always show normal levels of various types of leukocytes in the blood. What reasons can cause a deviation in the number of eosinophils from the norm, and what will the transcript tell the doctor about?

In rare cases, a decrease or even complete absence of eosinophils in the blood may be observed. This condition is called eosinopenia, it can be caused by a congenital characteristic of the body or a weakened immune system.

Sometimes eosinophils are absent in children with viral or bacterial diseases. Often eosinophils are low in a child who has suffered psycho-emotional stress or excessive physical exertion. These cells may be completely absent from the leukocytogram after injuries, burns or surgery.

Eosinophilia

In practice, much more common is a condition in which eosinophils are elevated, which has received the medical name eosinophilia.

The causes of eosinophilia in children are divided into the following groups:

There are 3 degrees:

• mild (eosinophils are increased in a child by no more than 10% of the total number of leukocytes),
• moderate (in a child, eosinophils make up 10% - 20% of leukocytes),
• severe (the child has increased eosinophils by more than 20% of the total number of leukocytes).

A mild degree is not dangerous. This is rather a borderline state between normal and pathological, which may simply be a reaction to short-term contact with an aggressive substance or be a concomitant diagnostic sign of chronic allergies.

A moderate degree creates the prerequisites for a more in-depth examination. In addition to determining the percentage of blood cells, it is necessary to determine the level of a specific peptide (cationic protein) and conduct an immunogram. This condition already requires correction.

Severe degree is a pronounced pathological process that is a direct threat to the child’s life. This condition is always a symptom of a severe disorder of the immune, hematopoietic or endocrine systems.

Symptoms of the disease

In infants and young children, external manifestations are quite pronounced:

• there is redness of the skin,
• the skin is rough to the touch, increased density,
• peeling, hair loss are observed on the scalp,
• when assessing muscle tone, hypertonicity is often detected and contractions of the muscles of the limbs, similar to convulsive ones, may appear,
• a wheezing cough is possible when breathing,
• due to swelling of the nasal mucosa, impaired nasal breathing.
• general manifestations are expressed in sleep disturbances and decreased appetite in infants.
• At the initial stages, the baby is capricious; later, on the contrary, it becomes apathetic.

At an older age, when verbal contact is possible, both children and adults describe the symptoms of general malaise more colorfully:

• headache,
• heart rhythm disturbance,
• dyspnea,
• gastrointestinal disorders,
• skin sensitivity disorders,
• the appearance of yellowish spots on the face and limbs,
• swelling of the face and limbs,
• neurological disorders intensify.

Since there are many reasons for an increase in eosinophils in a child’s blood, the symptoms may be different.

• Changes in appetite occur;
• Feeling lethargic and lack of strength;
• Itchy irritation of the anus occurs;

• Weight decreases;
• Muscle pain appears;
• Allergic reactions appear on the skin.

• Skin rash accompanied by itching;
• Runny nose, sneezing, swelling;

• Dry cough, difficulty breathing, asthma attacks;
• Itching, redness of the eyes, watery eyes.

Other diseases in which an increase in the number of this type of leukocytes is possible are more typical for adults. However, any changes in the child’s condition, along with a deviation from the norm as a result of the study, and especially when eosinophils are elevated in an infant, require additional attention from specialists.

Concern for the child pushes parents to seek additional examinations. To get a more accurate result, you should follow some rules for taking a clinical blood test:

• Since an increase in leukocytes follows after eating, it is best to donate blood on an empty stomach;
• Theoretically, the indicators also depend on the time of day at which the analysis was done, so it is preferable to do it in the morning;
• If the OAC is taken several times during the course of an illness, then it would be correct to observe the same conditions (for example, always in the morning and before meals) so that the indicators are affected by as few factors as possible;
• If the child is healthy and eosinophilia persists for a long time, it is worth taking a test for the level of total immunoglobulin E to determine the tendency to allergic reactions.

Dr. Komarovsky says the following about the increase in eosinophils in a child: “it can be present after illnesses, usually bacterial, at the stage of recovery. But if the child’s general condition is normal, then the increase in the number of eosinophils in itself should not cause concern in parents.

If the child is healthy, then it is best to monitor his condition and be examined (do an OAC) after about 3-4 months.

Treatment for eosinophilia

If the levels of eosinophils in a child's blood increase, treatment is primarily directed to the disease causing this symptom. The range of medications prescribed to the patient will depend on the type of underlying disease, its severity and stage, as well as the patient’s age. First-line drugs will be steroid hormones, antihistamines, immunosuppressants and metabolic drugs.

Indicators of the number of eosinophils for specialists are the most important diagnostic criterion for determining the functional state of the body.

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;
• helminth infections - 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 the mucus from the feces.

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, pronounced 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 can 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 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 a 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 helminthiases

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. Attempts to cure a child on your own using folk remedies will only do harm, as they 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.