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Suggest Treatment For Elevated Eosinophil Levels While Having COPD
Question: hi, I'm a 65 yr old white male living in Fl. In '07 I had a mechanical aortic valve implant and single posterior bypass--"warfarin" for life. So far, still "above the turf". I am also (still) a smoker with at least 50 pack yr. and diagnosed with copd via 2 or 3 PFT's over the last few years. I have a regular "pcp" who I visit monthly for my pt/inr's and any other maladies. I just recently "requested" a complete CBC---feel lousy generally, very poor appetite (eating, but living mostly on Boost) Also, for the last several years I have experienced "temporary" vision loss in my left eye. Opthamologist report negative. My recent "requested" CBC came back with a "surprise" (beyond the usual) : my Absolute Eosinophils came back @ 554---rather high. Checked against results from last years CBC (6/9/15) and that was only 330. My dr. also just performed a DNA swab test to check for any drug allergies, etc.---NO results on dna yet. My cholesterol is (as usual) "sky hi" --total = 281, LDL: 210, ratio 5.5, non hdl cholesterol 230--BAD! (also been on different statins multiple times with marginal to zero positive influence)--**I took myself off due to serious lower backaches and questionable side effects vs. benefits. I have occasional copd exacerbations and recently have fairly regular "major" (outrageous) sneezing fits. I'm on Spiriva and occasionally use my Ventolin (albuterol) for the copd flare-ups. My doc recently put me on an antibiotic for a week or two. I am now on Levocetirizine (antihistamine) (5mg) for 30 days ---seem (somewhat) better when on this stuff. My pcp also just 3 days ago ordered a DNA "swab" done for drug allergies, etc. This dna swab was done "after" my requested CBC---I don't have the results yet from the dna swab. My concern is this: what would cause the *sudden and rather *radical increase of absolute eosinopils to 554 from 330 from only last year? I've been doing some "homework" on eosinophilia-- that 554 can indeed be indicative of many cancers and multitudes of other maladies. How can they track down the "cause" before the investigating gets "invasive". Do I have cause for genuine concern and alarm of this 554? ***I'm well aware of the smoking and cholesterol issues, but this EOS has me scared. Am I dying (lung cancer, etc.??) ANY ideas??? (I know you can't legally give medical "advice") I'm asking your "opinion"...regards, XXXXXXX
Brief Answer:
Your COPD seems to be the cause.
Detailed Answer:
Thanks for asking on HealthcareMagic.
The cause behind increase in your eosinophil count is clearly discernable. A rise in eosinophil count indicates allergic reaction. As you should already be aware, the condition of your wheezing and COPD fluctuates with time. This actually has an allergic component and therefore it is not unlilkely for the eosinophil count to rise. Levocetirizine should help but taking Montair LC (monteleukast + levocetirizine) should be more beneficial but is a prescription medicine.
Other possible cause of rise in eosinophil count could be some worm infestation or filariasis. Unless you have definite symtoms, I would not really take these into account. Lung cancer will not give you raised eosinophil counts and this does not indicate that you are dying.
Let me know if I could help further.
Regards
Your COPD seems to be the cause.
Detailed Answer:
Thanks for asking on HealthcareMagic.
The cause behind increase in your eosinophil count is clearly discernable. A rise in eosinophil count indicates allergic reaction. As you should already be aware, the condition of your wheezing and COPD fluctuates with time. This actually has an allergic component and therefore it is not unlilkely for the eosinophil count to rise. Levocetirizine should help but taking Montair LC (monteleukast + levocetirizine) should be more beneficial but is a prescription medicine.
Other possible cause of rise in eosinophil count could be some worm infestation or filariasis. Unless you have definite symtoms, I would not really take these into account. Lung cancer will not give you raised eosinophil counts and this does not indicate that you are dying.
Let me know if I could help further.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi,
Thanks for your reply. Will the Monteleukast cross interfere with my warfarin?? (*"everything" does!) Is there any cross interference with Monteleukast and the Xyzal? Are they more beneficial and effective to use together or should the Xyzal be dropped in favor of the Monteleukast? Is the Monteleukast available as a generic?? I do NOT like the idea of "loading up" on pharmaceuticals--"at all"!! I do NOT take aspirin or NSAID's either *especially being on warfarin. **Will the results of the DNA allergy test generally lead the dr. in the "direction" of the "cause" of this increase of eosinophil? I've had copd for years, probably much longer than before it was actually diagnosed (50 pk. yrs) Is it *possible if I was in a house which has certain molds and dust in the air cause this increase? Living in Florida with all the humidity is a breeding ground for mold. I tried a home mold "self test kit" a few years ago which grew several *very large black and brown mold spots in the test dish after a few days. I never did have the test kits analyzed to find type or cause. There are NO areas of mold that can be *visually seen anywhere in the house---NO black spots on drywall or any visual tell-tale signs, but the test kit definitely found "something". The house also has always tended to be very dusty no matter how "clean" it's kept and regardless of regular changing of air filters. Could the home air quality cause this increase to 554, although the general home air quality has stayed pretty much the same for the last 35 yrs or so?? From what you state, it appears to me the majority of the problem stems from my copd flare-ups? I've had flare-ups for years and keep "all" my lab test results on file for comparisons. Why would I see such a radical increase in only the last several months over all these many years??
Thanks for your reply. Will the Monteleukast cross interfere with my warfarin?? (*"everything" does!) Is there any cross interference with Monteleukast and the Xyzal? Are they more beneficial and effective to use together or should the Xyzal be dropped in favor of the Monteleukast? Is the Monteleukast available as a generic?? I do NOT like the idea of "loading up" on pharmaceuticals--"at all"!! I do NOT take aspirin or NSAID's either *especially being on warfarin. **Will the results of the DNA allergy test generally lead the dr. in the "direction" of the "cause" of this increase of eosinophil? I've had copd for years, probably much longer than before it was actually diagnosed (50 pk. yrs) Is it *possible if I was in a house which has certain molds and dust in the air cause this increase? Living in Florida with all the humidity is a breeding ground for mold. I tried a home mold "self test kit" a few years ago which grew several *very large black and brown mold spots in the test dish after a few days. I never did have the test kits analyzed to find type or cause. There are NO areas of mold that can be *visually seen anywhere in the house---NO black spots on drywall or any visual tell-tale signs, but the test kit definitely found "something". The house also has always tended to be very dusty no matter how "clean" it's kept and regardless of regular changing of air filters. Could the home air quality cause this increase to 554, although the general home air quality has stayed pretty much the same for the last 35 yrs or so?? From what you state, it appears to me the majority of the problem stems from my copd flare-ups? I've had flare-ups for years and keep "all" my lab test results on file for comparisons. Why would I see such a radical increase in only the last several months over all these many years??
Brief Answer:
COPD is the main issue to be kept in consideration.
Detailed Answer:
Thanks for writing back. A lot of questions. Let me try to answer them.
Monteleulast interacts with warfarin but the effects are not clinically significant and may be ignored. See http://www.ncbi.nlm.nih.gov/pubmed/0000
Monteleukast goes well with Xyzal and the combination is a desirable one.
The DNA test is likely to indicate your genetic susceptibility towards allergy and should thus be related to the cause of raised eosinophil count.
Molds and dust may lead to aggravation of your symptoms and thereby the rise in eosinophil count. But whether you have seen such aggravations, remains to be correlated. There is nothing called 'home air quality' and I would not consider that.
COPD flare ups are the most likely cause of the rise in eosinophil count and all others are secondary. Future counts would also depend on the flare ups and nothing else. Since the flare ups cannot be predicted, the course of eosinophil count can also not be predicted.
However, let me emphasize that you are tearing your head apart on a meaningless thing. You should actually be concerned about your COPD.
Regards
COPD is the main issue to be kept in consideration.
Detailed Answer:
Thanks for writing back. A lot of questions. Let me try to answer them.
Monteleulast interacts with warfarin but the effects are not clinically significant and may be ignored. See http://www.ncbi.nlm.nih.gov/pubmed/0000
Monteleukast goes well with Xyzal and the combination is a desirable one.
The DNA test is likely to indicate your genetic susceptibility towards allergy and should thus be related to the cause of raised eosinophil count.
Molds and dust may lead to aggravation of your symptoms and thereby the rise in eosinophil count. But whether you have seen such aggravations, remains to be correlated. There is nothing called 'home air quality' and I would not consider that.
COPD flare ups are the most likely cause of the rise in eosinophil count and all others are secondary. Future counts would also depend on the flare ups and nothing else. Since the flare ups cannot be predicted, the course of eosinophil count can also not be predicted.
However, let me emphasize that you are tearing your head apart on a meaningless thing. You should actually be concerned about your COPD.
Regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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