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What Is The Blood Test For Eosinophilic Asthma

What Does A High Eosinophil Count Mean

An eosinophil count can help diagnose a few conditions. You might have a high count with the following:

High Number Of Eosinophils

Often, people are first tested and treated for more common causes of their symptoms. For example, they might undergo testing for infection and even receive antibiotics even though no infection is found. Because people still have symptoms after treatment, doctors often take a sample of tissue for examination , which will show eosinophils within the organ that is affected.

Treatment of these conditions frequently includes oral corticosteroids.

Symptoms Of Eosinophilic Asthma

A person who has EA typically has more severe asthma symptoms of coughing, wheezing, shortness of breath, and tightness in the chest. If you have attacks that land you in the hospital, it is possible that this is a symptom of EA. 

Other symptoms of EA are obstructed airflow due to inflammation and mucus. Think things like a stuffy nose and nasal drainage. Chronic sinus infections and nasal polyps are also symptoms. 

How Do Changes In Eosinophils Affect Health And Wellbeing

Allergies such as asthma can affect your everyday life, particularly at certain times of the year. For example, if you are allergic to grass pollen, your symptoms may be more prevalent during June and July. Eosinophil numbers increase during a parasitic infection or allergy.

If an increased eosinophil count is because of a parasitic or worm infection, then the symptoms can make you feel quite unwell. Plus, an infection can cause a reduction in energy levels, making you feel weak and tired.

If you are worried about your immune system or just want to check where you fall on the range, you can test your eosinophils level with a simple at-home blood test.

A Simple Calculation Using Routine Blood Test Results Can Identify Eosinophilic Asthma Patients


Complete blood count with differential, a standard test that enumerates different types of white cells in peripheral blood, is often performed during routine patient visits in clinics and hospitals. The test can be used to differentiate between normal condition in healthy people and infection and inflammation in patients. Results of CBC with differential show absolute counts of total white blood cell and its constituents: eosinophils, lymphocytes, neutrophils, basophils, and monocytes.

Abnormally high levels of eosinophils in peripheral blood of asthma patients have been associated with a type of severe asthma. Although severe asthma patients constitute only 5-10% of total asthmatic population, higher frequency of asthma attacks and hospitalizations in such patients consume a disproportionate amount of financial resources available for treatment and healthcare.


How Is Eosinophilic Asthma Diagnosed

The initial step in Eosinophilic asthma diagnosis is evaluate your condition and this evaluation involves:

  • shortness of breath with exercise
  • limited airflow
  • chronic sinus disease

After evaluation, there may be a case that you have diagnosed with asthma but what if you are not responding well to the treatment? Your doctor may be suspicious regarding another type of asthma and will analyze your condition. He/she may also look for the additional signs and symptoms to get it diagnosed.

The most common and easiest step to check for Eosinophilic asthma is to check the white blood cells count. To diagnose the condition your doctor will collect blood, saliva or sputum for examination. Increased eosinophils levels can affirm your doctors suspected diagnosis.

A Brief Note On Eosinophils:

Our bodys immune system make use of WBCs or white blood cells to fight off bacteria, viruses and other foreign particles that could cause infection and illnesses. However, it does not just use one WBC type to do it. Instead, there are several types of immune system cells; and these include eosinophils.

Eosinophils are made by the body in the bone marrow. They normally take a week to completely mature. Eosinophils play a vital role in the overall immunity of an individual. Adequate levels of eosinophils are required for the body to function normally and smoothly.

It must be mentioned that although eosinophils are part of immune system, some of their responses are not always healthy for the body. Sometimes these esinophils play a part in conditions like food allergies and inflammation in the tissues of the body.

How To Reduce Eosinophil Count Or What Are The Treatments

Eosinophils can be reduced if the proper treatment has been given for the condition causing it. Although, most of them need supportive care while on treatment. Hence, this depends what their conditions are. Pain management drugs, IV fluids and supportive treatments are given to the patients when they are hospitalized due to certain conditions.

Hence, the underlying causes of eosinophilia are first treated to decrease the eosinophil counts. Oxygen treatment is given for pulmonary eosinophilia. Corticosteroid treatment is administered for the people suffering from allergies but this can sometimes cause problem if they have any prior infections of fungi or parasites because it may still worsen them. Interferon can be used along with many other drugs if one has steroid resistant diseases.

If there is no organ involvement in the patient and has primary eosinophilia then no treatment might be required.Cardiac function to be measured at regular intervals, nonetheless, as peripheral eosinophilia does not essentially associate with organ involvement. So steroid responsiveness must be evaluated. This is needed for prognosis as steroid-responsive patients will perform better and when needed the treatment to be guided.

Eosinophils blood test should be done every six months to check if everything is normal. Try to build your immunity by increasing the consumption of green leafy vegetables and also fresh fruits to make sure that you are getting appropre proteins and vitamins.

Diagnosis: What Does A Patient With Sea Look Like

Early identification of patients with SEA in clinical practice is important; however, identifying these patients in day-to-day practice is not always straightforward . A key initial step, as described by the European Respiratory Society /American Thoracic Society severe asthma guidelines, is to confirm the diagnosis of asthma and address comorbidities. Secondly, adherence to therapy and inhaler technique must be assessed before a diagnosis of severe uncontrolled asthma refractory to treatment can be confirmed . This phenotype has been variously described in the literature and cluster analysis suggests a phenotype of patients with late-onset, eosinophilic, inflammation-predominant asthma .

Adult-onset asthma patients with a high blood eosinophil count have been found to have a distinct phenotype of severe asthma with frequent exacerbations and poor prognosis . Persistent airflow limitation and distal inflammation with air trapping are common in these patients, as is upper airway pathology such as chronic rhinosinusitis with nasal polyposis . The characteristics described in these and other studies are not ubiquitous in all patients . As such, classification using a set of major and minor diagnostic criteria may help to identify this pattern .

Possible diagnostic scheme for severe eosinophilic asthma

How Is Eosinophilia Treated

Treatment depends on the cause of the condition. Treatments might include stopping certain medications , avoiding certain foods , or taking an anti-infective or anti-inflammatory medication. Treatments that target eosinophils in asthma specifically have been approved by the Food & Drug Administration and are being used in the clinic, while treatments for other eosinophil-mediated conditions are under further investigation.

What Does It Mean When You Have High Eosinophil Count

High levels of Eosinophils or high eosinophils counts in the blood is also known as Eosinophilia. This level ranges between 500 to 1500 per microliter of blood. A high eosinophils count may indicate a number of conditions, such as, allergies, asthma, inflammatory conditions like, Celiac disease or Inflammatory bowel disease, abnormal blood clells or Hypereosinophilic myeloid neoplasms, Eczema or dermatitis or other inflammatory skin conditions, parasitic infections, reactions to medications, or Cancerous growth including Hodgkins disease.

There may be a high level of eosinophils not only in the blood, but also in the bodys tissues. Because an underlying condition causes high eosinophils count, having high levels of eosinophols can cause several symptoms in a person. One must talk to doctor in such case and find out professional ways to treat eosinophilia.

Types Of Severe Asthma

There are two main categories of severe asthma Type-2 inflammation and Non-Type-2 inflammation. These categories are based on a persons response to treatment. Type-2 inflammation includes allergic asthma and eosinophilic asthma and Non-Type-2 inflammation includes non-eosinophilic asthma. For example, allergic asthma and e-asthma respond to treatment with inhaled corticosteroids and IgE -directed therapy or other biologics listed in the above table. Patients with Non-Type-2 inflammation, including non-eosinophilic asthma, generally do not respond well to inhaled corticosteroids. Allergic asthma and e-asthma have distinct biomarkers and treatment options available today. Treatments for non-eosinophilic asthma are currently being development.

Allergic asthma is caused by exposure to allergens such as pollen, pet dander, molds, etc. Most people diagnosed with allergic asthma will also have a diagnosis of hay fever or rhinitis. For these patients, exposure to allergens causes the bodys immune system to produce immunoglobulin E, an antibody that attaches to certain cells and causes them to release chemicals creating an allergic reaction. When this happens, common symptoms are sneezing, itchy/watery eyes, severe allergic reactions , and increased airway sensitivity.

Non-eosinophilic asthma includes neutrophilic, smooth-muscle mediated and mixed cells. People in this subgroup have few to no eosinophils in test results, and do not respond well to inhaled corticosteroids.

How The Test Is Performed

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Most of the time, blood is drawn from a vein on the inside of the elbow or the back of the hand. The site is cleaned with an antiseptic. The health care provider wraps an elastic band around your upper arm to make the vein swell with blood.

Next, the provider gently inserts a needle into the vein. The blood collects into an airtight tube attached to the needle. The elastic band is removed from your arm. The needle is then removed and the site is covered to stop bleeding.

In infants or young children, a sharp tool called a lancet may be used to prick the skin. The blood collects in a small glass tube, or onto a slide or test strip. A bandage is put on the spot to stop bleeding.

In the lab, the blood is placed on a microscope slide. A stain is added to the sample. This causes eosinophils to show up as orange-red granules. The technician then counts how many eosinophils are present per 100 cells. The percentage of eosinophils is multiplied by the white blood cell count to give the absolute eosinophil count.

When Is Quick Relief For Asthma Not Enough


  • Take your quick relief inhaler more than TWO TIMES A WEEK?
  • Awaken at night with asthma more than TWO TIMES A MONTH?
  • Do you refill you quick relief inhaler more than TWO TIMES A YEAR?
  • Use prednisone TWO or more times a year for flares of asthma?
  • Measure changes in peak flow with asthma symptoms of more than TWO TIMES 10 ?

If you answer YES to any of the questions, current guidelines suggest you talk with your physician about adding an inhaled anti-inflammatory to improve your asthma control.

How Are The Results Of Mucus Eosinophil Testing Used

More research is needed on how to use the results of this test in everyday practice. In studies, adjusting treatment based on eosinophil levels has been helpful. People who were treated until their mucus eosinophil levels were normal had better control of their asthma, fewer asthma attacks, and fewer hospitalizations.1

What Is An Eosinophil Count

If you take a blood test and the results arent in the normal range, your doctor may recommend more tests to figure out the problem. If this happens on a test called a white blood cell differential, you may need to get another blood test called an absolute eosinophil count. You might also get this test if your doctor thinks you have a particular kind of disease.

Be Prepared For A Doctors Appointment Beforehand:

Sufferers with a suspected asthma or asthma will be referred to a pulmonologist or an allergist. So, we have prepared a list of tips that may prove helpful to get you prepared for the doctors appointment:

  • Dont forget to keep a proper record of the symptoms you are having, even if they are seemingly unrelated.
  • Remember to maintain and bring a list of medications you are taking be it vitamins, over the counter medications, or the supplements.

Prepare list of questions that you have in your mind like:

  • What tests can be performed For Eosinophilic Asthma?
  • How should I use my medications?
  • What are the triggers for asthma flare ups?
  • Can I do anything to reduce the risk of having an asthma attack?
  • Do I need to change my diet?
  • Can I restrict the use of inhalers?
  • Is there any elimination diet?
  • How often do I need follow-up care?

Treatment And Medication Options For Eosinophilic Esophagitis

Some medications approved for other conditions that may help symptoms of EoE include:

  • Proton Pump Inhibitors  These drugs lessen acid production in the stomach and may reduce inflammation in the esophagus. But, not all patients with EoE respond to PPIs.
  • Topical Steroids They can help control inflammation in the esophagus. You swallow the liquid steroid. The type of steroids doctors typically prescribe for EoE isnt absorbed in the bloodstream, so you probably wont experience side effects normally associated with steroids.

Your First Appointment At The Specialist Asthma Clinic

At the first appointment your asthma consultant will want to know everything about your medical history and your lifestyle.

Youll be asked a lot of questions about you and your asthma, many of them your GP may already have asked you. It might be frustrating to be answering them again, but the clinic specialists want to build a complete picture of you and your asthma.

Have a list of all your medicines because youll be asked about what youre taking, including the doses and how you are taking them. They will also want to know about your symptoms and how your asthma affects your quality of life and the people close to you. 

This is your chance to explain what impact asthma is having on you and the people close to you. The more open and honest you can be, the better chance youll have of getting the right diagnosis, support and treatments.  

So, If youre struggling to take your medicines as prescribed or youre getting unpleasant side effects from them, let the specialist know.

Who Gets Access To My Information

Once you create a password-protected account, you will be the only one with access to your order information and lab test results, with the exception of PWNHealth. PWNHealth will only disclose your personal information to providers, labs, and contractors used to provide services, who are required to keep such information confidential, to the extent required by law. For additional information, please review the Privacy Noticehere.

AstraZeneca does not have visibility into the lab results for individual participants.

Why Should I Get Tested

How is eosinophilic asthma treated â Health Blog

If you have asthma and are using your rescue inhaler frequently, if you wake up at night due to asthma symptoms, if you take oral steroids like prednisone, and/or if your asthma attacks have required emergency care, then your asthma might be uncontrolled. A blood test, along with speaking to your primary care provider or an asthma specialist, may help determine if you have e-asthma, and if further evaluation of your asthma is necessary. Talking with your physician about the test results may help identify your type of asthma and additional treatment options to help control your asthma.

Asthma Uk Community Forum

My consultant at the Royal Brompton wants me to have a blood test to check for eosinophils when I have an asthma flare up and before starting pred. He is also happy for me to stay on a low dose if I need to, I’m currently on a very slow taper. Was just wondering if a low dose of pred 5 or 10mg would affect the results. Has anyone had the blood test while on pred? my cons is hoping I might become candidate for biologicals.

I had a blood test while on 50mg pred a few years back and my eosinophils came back at 0.01, despite my non-pred levels being 1.5-1.7 ish. So I would say a high dose of pred definitely affects eosinophils.

My cons wanted a baseline eosinophil level too a while ago, and he asked me to taper all the way down and be completely off pred for 2-3 weeks before having the bloods, so the levels would be accurate. I have to say it was a bit of a challenge trying to come completely off mid-winter inbetween multiple chest infections! It might be that eosinophils while on 5mg/10mg pred might be closer to your ‘normal’, but they’ll probably still be lower than they would be off pred completely. The most accurate test would be while off pred , but obviously that’s quite a while to go without pred.

Prep Procedure And Result Interpretation Of Aec Test

First and foremost, there is no need for any special preparation for the test. Just inform the physician if youre having any blood-thinning drugs like warfarin . Apart from these a few drugs need to be forgone before the test. Your doctor will advise you to stop taking certain medications.

Medications to avoid include diet pills, interferon, a few kinds of antibiotics, laxatives having psyllium, and tranquilizers. Also, ensure your doctor knows all the medicines that you are taking both current and very recent.

Once you are done with saying these a technician will draw a sample of blood which will be sent for further examination. The blood is drawn using a needle.

Following the result, if you get normal results it means you have fewer than 500 eosinophil cells per microliter of blood however, in children it varies depending on age.

In case, you have above 500 eosinophil cells per microliter of blood which is known as eosinophilia- a kind of disorder that is again the onset of many conditions.

If theres an unusually low eosinophil count it can be due to intoxication or the disproportionate creation of cortisol.

This in brief is what an absolute eosinophil count blood test is all about.

What Are The Complications Associated With An Eosinophil Count

An eosinophil count uses a standard blood draw, which you have likely had many times in your life.

As with any blood test, there are minimal risks of experiencing minor bruising at the needle site. In rare cases, the vein may become swollen after blood is drawn. This is called phlebitis. You can treat this condition by applying a warm compress several times each day. If this isnt effective, you should consult your doctor.

Excessive bleeding could be a problem if you have a bleeding disorder or you take blood-thinning medication, such as warfarin or aspirin. This requires immediate medical attention.

What Can I Do To Lower The Eosinophil Count In The Blood

If there is a mild transient eosinophilia with no symptom, no action is necessary. The count probably will return to normal in the following test.

On the other hand is there is a moderate or severe eosinophilia you should visit your doctor and ask about the medication you are taking. Several drugs may raise the eosinophil count.

If there is an underlying cause, for example a parasitic infestation it is necessary to treat and solve previously this disease.

Corticosteroids reduce the eosinophils in the blood. If your doctor considers it appropriate he may prescribe them to you.

What Are Inflammatory Biomarkers For Asthma

Eosinophils are inflammatory cells with an important role in asthma. About half of people with asthma have high eosinophils. Also, people with more eosinophils tend to have more severe asthma. Testing biomarkers for asthma often depends on measuring quantities of eosinophils.1,3

Examples of biomarkers of inflammation for asthma include:2,4

  • Exhaled nitric oxide, a measure of the amount of nitric oxide in your breath, which is linked to increased eosinophils in the airway
  • The percentage of eosinophils in the mucus from your lungs
  • The percentage of eosinophils in a blood sample

Measured exhaled nitric oxide is a more common test your asthma specialist may perform. Blood and mucus eosinophils are mainly measured for researchpurposes. This information is used for studies that are trying to define different types of asthma and for studies of new treatments. More information is needed about how to use the results of these tests in everyday practice.1,5

Another inflammatory biomarker that is still being researched is called periostin. Periostin is a protein made by the cells in your airway. People with asthma may have higher levels of periostin. However, the research on asthma and periostin is in the early stages, and testing is not yet common.2,4

Eosinophilic Asthma Blood Test

The number of eosinophils in a patients blood are measured. The blood draw is a simple, minimally-invasive procedure. It may be performed in a doctors office. People with eosinophilic asthma will have a high eosinophil count . High eosinophils with asthma does not always mean that a person has eosinophilic asthma. Other types of eosinophil-associated disease can cause too many eosinophils in the blood as well. Therefore, a doctor will interpret the results in context with a patients history, symptoms, and clinical exam.

What Are The Most Common Symptoms

An increase in the numbers of eosinophils is typical of atopic asthma. Symptoms of atopic asthma are:

  • Wheezing which sounds like whistling when breathing
  • Breathlessness
  • A tight chest like a band tightening around it

A severe asthma attack may cause the following symptoms:

  • Severe and constant wheezing, coughing and chest tightness
  • Breathlessness so severe that you are unable to speak, eat or sleep
  • Fast heartbeat
  • Drowsiness, confusion, exhaustion or dizziness
  • Fainting

Common symptoms of a parasitic infection are:

  • Diarrhoea

It Can Take Time To Get A Severe Asthma Diagnosis

Eosinophils Blood Test Procedure

Many people with severe asthma have already had asthma for some time and have tried different combinations of drugs. Just as theres no one-off test to diagnose asthma instantly, theres no single test to find out if the type of asthma you have is severe asthma. This means it can take time to get a diagnosis. The process and length of time will vary from person to person. 

You can call our Helpline and speak to one of our respiratory nurse specialists on 0300 222 5800 or message them via WhatsApp on 07378 606 728  to ask any questions you have about your new diagnosis.

Next review due June 2022

Testing For Severe Asthma

Before you can be tested for severe asthma, you will need a referral from your primary healthcare asthma provider to either an asthma specialist or allergy specialist . The specialist will review your medical history, your current asthma treatment plan and do a physical exam to assess your symptoms. If the specialist thinks you may have severe asthma, they will discuss additional testing with you to determine your specific type. This often starts with testing to identify a biomarker.

Biomarkers help determine what is causing the inflammation in your airways. Taking a blood sample, analyzing a mucus sample or taking a breathing test that measure substances in your breath droplets are all common tests doctors use. These tests are performed in a doctors office or an outpatient clinic setting. Your specialist will recommend one or more of these tests based on your medical history and current symptoms. Once the biomarkers are identified, your doctor can determine the type of severe asthma and the different treatment options that are available to treat that specific type.

Why Do I Need An Eosinophil Count

Your doctor may discover abnormal eosinophil levels when a white blood count differential is performed. A white blood count differential test is often done alongside a complete blood count and determines the percentage of each kind of white blood cell present in your blood. This test will show if you have an abnormally high or low count of white blood cells. White blood cell counts can vary in certain diseases.

Your doctor may also order this test if they suspect specific diseases or conditions, such as:

  • an extreme allergic reaction

Before the test, be sure to tell your doctor about any current medications or supplements youre taking.

A healthcare provider will take a sample of blood from your arm by following these steps:

  • First, theyll clean the site with a swab of antiseptic solution.
  • Theyll then insert a needle into your vein and attach a tube to fill with blood.
  • After drawing enough blood, theyll remove the needle and cover the site with a bandage.
  • Theyll then send the blood sample to a laboratory for analysis.

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