Eosinophilic asthma (EA) is a severe type of asthma that is characterized by a high amount of white blood cells known as eosinophils. An essential part of the body’s immune system eosinophils help fight infections by destroying any type of invading bacteria. However, in individuals suffering from EA, this type of white blood cells lead to swelling and inflammation in the respiratory system. EA is a rare condition and as compared to other forms of asthma, it can be challenging to treat.

What are the symptoms of eosinophilic asthma?
If one notices any signs, they should immediately consult a pulmonologist.

• Shortness of breath
• Coughing
• Wheezing
• Tightness in the chest area and obstructed airflow
• Nasal polyps
• Symptoms of chronic sinus infection including nasal drainage, stuffy nose, and a diminished sense of smell
• Abnormally high number of eosinophils in the blood

Some of these above-stated symptoms of EA closely resemble the symptoms of COPD (chronic pulmonary obstructive disorder) rather than the classic symptoms of asthma. Therefore, a proper diagnosis is imperative to rule out other medical possibilities and initiate the right treatment options.

How is eosinophilic asthma diagnosed?
The doctors haven’t been able to narrow down the exact cause of EA. Unlike other forms of asthma which are prompted by allergies to environmental factors such as pet dander, dust mites or pollen, EA doesn’t have any such triggers. To rule out the likelihood of severe asthma, the pulmonologist’s diagnostic measures will involve the use of –

• Corticosteroids to understand the respiratory system’s response
• Blood tests to gauge the levels of eosinophil
• Bronchial biopsy

How is eosinophilic asthma treated?
Typically, the treatment for eosinophilic asthma involves the use of a rescue inhaler and inhaled corticosteroids. However, some EA patients might not respond well to this conventional treatment option. Therefore, apart from these alternatives, the eosinophilic asthma treatment aims at reducing the inflammation caused by the white blood cells. Controlling the inflammation levels can prevent episodes of EA attacks.

Alternative treatments to manage the symptoms of EA

• Corticosteroids – Inhaled corticosteroids might not be the best choice for every patient, so the pulmonologist can prescribe oral corticosteroids. On the downside, oral corticosteroids have more side-effects. Therefore, one should discuss the potential side-effects with the doctor before using these medicines.
• Biologic therapies – The medicines used in this type of treatment inhibit the chemicals in the body that trigger swelling and inflammation. These are administered via an injection or IV (intravenous) drip.
• Leukotriene modifiers – Leukotrienes are a type of compound in the body that causes inflammation just like high levels of eosinophils. Leukotriene modifiers are medications that fight these compounds to prevent or control the inflammatory response.
• Rescue inhalers – Fast-acting or rescue inhalers are often prescribed to asthmatic patients. However, in the case of EA, they can gradually lose their effectiveness.

What are the complications caused by eosinophilic asthma?
Unfortunately, if not treated properly, EA can impact the quality of one’s life, as the swelling and inflammation of the respiratory system can cause permanent tissue scarring. Such damage can make EA treatment ineffective as time passes. Therefore, one should quickly get medical attention if an EA flare-up occurs.

Individuals dealing with EA may also experience the following complications –

• Inner ear infections
• Chronic sinus infections
• Aspirin-exacerbated respiratory disease (AERD), a chronic condition that resembles eosinophilic asthma
• Nasal polyps
• Eosinophilic diseases of the gastrointestinal tract such as eosinophilic gastroenteritis (EG) and eosinophilic enteritis (EE)

The key to manage EA is consistent treatment so that the risk of damage and complications can be prevented. Likewise, a person with EA should also adopt some self-management measures such as exercise, healthy diet, and ample of rest to keep the immune system strong.