Dr. Hive: high eos?

[Tiramisu]

I'm still looking at dd's bloodwork and have been getting answers to the things that were flagged. There's one last thing that I'm confused about. For background, my sporty dd has been uncharacteristically fatigued and is negative for mono and thyroid issues. She is iron deficient but not anemic.

 

So, my question today is about an eosiniphil count (percent) that is out of range. Normal is 0-4% and hers is 9%. The absolute count is at the very top end of normal. I really wouldn't worry about this if it weren't for how tired she's been, but because she is, I'd like to know if this is someting I should ask about. The pediatrician did not mention it and I only saw it when the lab report came in the mail.

[Tiramisu]

I always thought eosinophils were high when a person was suffering from allergies. Maybe inflammation.

 

 

Thanks. That's what I found when I looked it up. Allergies and parasites are the most typical explanation. I don't see obvious signs of either, though I know allergies can kick in at any time and can make you tired. She's had contact dermatitis before but nothing noticeable in years.

[MomatHWTK]

eos in the digestive system can cause malabsorption. Check the Cincinnati Children's Hospital website for information on eosinophilic disorders.

[Tiramisu]

eos in the digestive system can cause malabsorption. Check the Cincinnati Children's Hospital website for information on eosinophilic disorders.

 

I know a little about EE because of a friend's situation. Is it possible that she could have a real eosinophilic disorder without more symptoms? She had gone through a situation of feeling nauseous at night and feeling like she was having difficulty breathing when she would like down. I thought it was anxiety because of a major medical situation and it did pass. The nausea got better after she cut down on dairy. I assumed she was lactose intolerant. Would you recommend allergy testing as a first step?

 

Thank you!

[Mommyof4ks]

I always thought eosinophils were high when a person was suffering from allergies. Maybe inflammation.

 

This. I get extremely tired with allergies, like can't keep my eyes open without allergy meds tired. Also, even if the tests show she is only slightly iron defiencet know that for her that might be enough to affect her when it would not affect other people.

[kalanamak]

Machine count or a manual?

 

If it is a concern, a peripheral smear is much more accurate. I can't tell you how many unexpected "odd" differentials disappear when reviewed by an experienced eye looking at a slide gotten from a finger prick rather than a tube full of preservative.

 

BTW, the only time elevated eos have tipped me off to anything, they have been *markedly* high. I recall one very nice one-legged homeless man with 35% eos. My intern rushed down and exclaimed that it must be cancer. I, lowly student, said, "Shall we repeat after his whole body case of scabies is treated?" It was the scabies.

[Tiramisu]

The bloodwork was done at Labcorp so I'm guessing machine.

 

The only time she had bloodwork before was prior to her surgery. I could call medical records and see if the eos were elevated then. That *could* indicate a long-standing, unrecognized allergy, but won't explain what's happening now. (You probably can tell that I really don't want to put her through bloodwork again after the latest episode.)

 

It took several months before my older dd showed an improvement with iron supplementation. So that might be a long haul to see if that's the cause of the fatigue. <_<

[Halftime Hope]

OP, it sounds like blodwork is torture for your dd.

 

Like Kalanamak said, the labwork is much easier if they do a finger stick (not with a spear-shaped manual lancet like the old days, but now with one of the finger-stick lancet pens like diabetics use). They can get a drop or two of blood and not have to go on one of the excruciating expeditions to try to find an elusive vein. I used to hate the old lancets with a purple passion. I'd rather have blood drawn, because my finger felt like it had been hit with a Mack truck. The lancets they have used in the last 15 years are tiny, and almost always pain free, or very nearly so.

 

I think your doc would have to order labwork done manually at the lab, but it can be done.

[Tiramisu]

OP, it sounds like blodwork is torture for your dd.

 

Like Kalanamak said, the labwork is much easier if they do a finger stick (not with a spear-shaped manual lancet like the old days, but now with one of the finger-stick lancet pens like diabetics use). They can get a drop or two of blood and not have to go on one of the excruciating expeditions to try to find an elusive vein. I used to hate the old lancets with a purple passion. I'd rather have blood drawn, because my finger felt like it had been hit with a Mack truck. The lancets they have used in the last 15 years are tiny, and almost always pain free, or very nearly so.

 

I think your doc would have to order labwork done manually at the lab, but it can be done.

 

Thanks for your suggestion. I know they check anemia this way but I didn't think of it for other things. If they couldn't do it locally, I'm sure I could get it done at a children's hospital.

 

I got an email that the specialist suggested we come in for a visit since we haven't been there in a while. The reason we didn't go back is because dd's stomach issues resolved, and I don't want to bring her in just to bring her in. I was just hoping for another doctor to look at the numbers and tell me if the small collection of flagged things could be relevant to the fatigue and something to be concerned about, and if so, tell me where to go. I've been on the medical circuit with my oldest and I'm not ready to get into it again if there's not a clear reason--and this one wouldn't handle it well.