ABSTRACT
Background: Asthma is a chronic inflammatory condition of the airways resulting in increased airway reactivity to a variety of stimuli like allergens, irritants, viruses and exercise. There is a strong association between the exposure of allergens and development of asthmatic symptoms. A hypersensitivity reaction initiated by immunologic mechanisms mediated by Immunoglobulin E (IgE) antibodies occurs in allergic asthma. IgE and eosinophils play an important role in the inflammatory process resulting in bronchial hyperresponsiveness. The aim of this study was to evaluate serum total IgE levels and Absolute Eosinophil Count (AEC) as markers of disease activity and study their association with the severity of bronchial asthma in children.Methods: A prospective study was conducted in the paediatric department of a tertiary care hospital in Ahmedabad, Gujarat, India from July 2017 to December 2018. Children between 4-14 years of age diagnosed as having bronchial asthma were included in the study. Serum total IgE levels and absolute eosinophil count were done in all the study participants and their correlation with the severity of asthma was assessed.Results: Of the total 109 patients of asthma, 44(40.4%) had intermittent asthma, 30(27.5%) mild persistent, 25(22.9%) moderate persistent and 10(9.2%) severe persistent asthma. Serum total IgE levels were raised above the normal limits for age in 94(86.2%) patients and increased AEC was found in 61(56 %) patients. Both serum total IgE levels and AEC increased significantly (p<0.0001) with increasing severity of asthma.Conclusions: Serum total IgE levels and AEC can be used to predict the severity of asthma in children.
ABSTRACT
Allergic rhinitis is an IgE mediated hypersensitivity disease of the mucous membrane of nasal airway characterized by sneezing, itching, watery nasal discharge and sensation of nasal obstruction.METHODSThe aim of the study was to evaluate the total serum IgE levels and absolute eosinophil counts in patients with allergic rhinitis, and rhinitis with asthma. In this study, 160 patients of allergic rhinitis attending ENT OPD were clinically examined and investigated with Total Serum IgE levels and absolute eosinophil counts. Statistical analysis was done using SPSS software.RESULTS160 study subjects with signs and symptoms of allergic rhinitis were investigated with total serum IgE levels and absolute eosinophil count. 46.25% were males and 53.75% were females. The patients included in the study were aged 10-60 years. Seasonal symptoms were observed in 44% of patients while perennial symptoms were experienced by 56% of the patients. As per ARIA classification, 66.3% had mild, 6.9% had moderate and 26.9% had severe allergic rhinitis. Bronchial asthma was found to be the most common comorbidity present in 13% of subjects, associated sinonasal polyps which was present in 13.8%. 71.9% had raised Total Serum IgE levels and eosinophilia was present in 59.4%. A significant relationship exists between total IgE levels and eosinophilia in patients with allergic rhinitis.CONCLUSIONSAllergic rhinitis is an IgE mediated inflammatory disease and raised total serum IgE levels and raised absolute eosinophil count in study subjects with clinical signs and symptoms of rhinitis are likely to correlate with allergic aetiology.
ABSTRACT
Background: Bronchial asthma is defined as chronic inflammatory disease of the airways that is characterized by increased responsiveness of the tracheobronchial tree to a multiplicity of stimuli. Eosinophil infiltration is a characteristic feature of asthmatic airways. It presents as an obstructive type of ventilator defect usually diagnosed from a reduced FEV1% (Forced Expiratory Volume) or from a reduced peak expiratory flow (PEF) associated with reduced airway caliber during expiration. Allergen inhalation results in a marked increase in activated eosinophils in the airways. Correlation between the degree of bronchial hyperresponsiveness (a cardinal feature of asthma) and peripheral blood eosinophilia has been observed in patients with dual response following allergen challenge.Methods: The study comprises a total number of 50 bronchial asthma patients of both sexes (male and female) between the age groups of 13-65 years. Based on severity, asthma patients were classified into mild, moderate and severe asthmatics, assessed by FEV1% computerized Spirometry Helios model number 701, recorders and medicare system. Peripheral blood sample was collected from each patient for absolute eosinophil count, the count was done on the same day.Results: The mean±SD absolute eosinophil count of 50 patients is 330±88.64 which is slightly above normal (300 cells/mm3). Author found that the mean±SD absolute eosinophil count of 405±83.16 in severe asthma patients is quite high, corresponding with a steep decline in the FEV1% 45.3±12.6.Conclusions: Absolute eosinophil count and FEV1% are important indicators of bronchial asthma severity and can even be used to predict disease progression.
ABSTRACT
Anticonvulsant hypersensitivity syndrome (AHS) is a potentially fatal drug-induced, multi-organ syndrome. The syndrome has been reported with anticonvulsants such as carbamazepine, phenytoin, phenobarbitone, and lamotrigine. A 17-year-old female who presented with papules and desquamation all over was diagnosed with AHS. She gave a history of fever, earache, peripheral edema, and erythematous papular eruptions 3 days prior. She gave a history of carbamazepine treatment since 15 days for generalized tonic-clonic seizures. On examination, there was cervical lymph node enlargement without tenderness. Investigations revealed elevated absolute eosinophil count at 550/mm3 and positive C-reactive protein tests. Carbamazepine was immediately withdrawn. Symptomatic treatment was administered, and resolution of the symptoms was observed. In this case, causalty assessment using Naranjo adverse drug reaction probability scale showed that carbamazepine was a probable cause for the AHS (Score - 7).
ABSTRACT
The present study aimed to evaluate the anti-asthmatic activity of the hydro-alcoholic extract of Citrullus colocynths and Cucumis trigonus (Cucurbitaceae) fruits on Ovalbumin induced Asthma in rats. Extracts were prepared with 70% v/v ethanol using cold maceration followed by Soxhlation. Hydro alcoholic extract (200 and 400 mg/kg) of both fruits were evaluated for anti asthmatic activity on ovalbumin induced Asthma in rats with the help of parameters like, absolute eosinophil count in BALF, total leukocyte count in the BALF, absolute eosinophil count in the Blood, IgE antibodies in serum and histopathological findings of lungs. Both plants were showed significant anti asthmatic activity (p < 0.001) with dose of 200 & 400 mg/kg when compared with disease group. Obtained results were almost similar to that of normal group. With the same dose, C. colocynths was shown better anti asthmatic activity than C. trigonus. Hence, further detailed studies are required to evaluate the efficacy of these plants on anti-asthmatic activity.
ABSTRACT
Benign conditions like Tropical Pulmonary Eosinophilia(TPE) can present with very high total count and Absolute Eosinophil Count (AEC) and can mimick malignancy. Diagnostic work up for TPE should be done in any patient presenting with pulmonary symptoms and eosinophilia. Though most case series on TPE report AEC in range of 3000 to upto 20,000, very rarely AEC can rise beyond 50,000. The following case is of TPE presenting with absolute eosinophil count of >70,000. Rapid response to Diethyl carbamazine is the rule in a confirmed case of TPE.