Summary about Disease
Eosinophilic asthma is a severe type of asthma characterized by an elevated number of eosinophils (a type of white blood cell) in the blood, lungs, and sputum. These eosinophils cause inflammation and swelling in the airways, leading to asthma symptoms. This form of asthma is often not well controlled with standard asthma treatments and may require more targeted therapies.
Symptoms
Symptoms of eosinophilic asthma are similar to those of typical asthma, but often more severe:
Wheezing
Shortness of breath
Chest tightness
Coughing (often chronic)
Increased mucus production
Fatigue
Nasal congestion and sinus issues (in some cases)
Asthma exacerbations (flare-ups) that require emergency medical attention
Causes
The exact cause of eosinophilic asthma is not fully understood, but it involves a complex interaction of genetic and environmental factors. It's thought that:
Immune System Dysregulation: The immune system overreacts to triggers, leading to increased eosinophil production.
Genetics: A predisposition to allergies or asthma can increase the risk.
Environmental Factors: Exposure to allergens, pollutants, or respiratory infections might trigger or worsen the condition.
Underlying conditions: Nasal polyps, chronic rhinosinusitis, and aspirin-exacerbated respiratory disease (AERD) are often associated with eosinophilic asthma.
Medicine Used
Treatment for eosinophilic asthma often includes:
Inhaled Corticosteroids (ICS): Reduce airway inflammation.
Long-Acting Beta-Agonists (LABA): Relax airway muscles (often used in combination with ICS).
Leukotriene Modifiers: Block the action of leukotrienes, which contribute to inflammation.
Oral Corticosteroids: Used for severe exacerbations (short-term use).
Biologic Therapies: Targeted therapies that reduce eosinophil levels or block inflammatory pathways. Examples include:
Mepolizumab (Nucala)
Reslizumab (Cinqair)
Benralizumab (Fasenra)
Dupilumab (Dupixent)
Bronchial Thermoplasty: A procedure to reduce smooth muscle in the airways.
Is Communicable
No, eosinophilic asthma is not contagious. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
Avoid Triggers: Identify and avoid allergens, irritants, and pollutants that worsen symptoms.
Adhere to Medication: Take prescribed medications as directed by your doctor.
Monitor Symptoms: Regularly track symptoms and lung function using a peak flow meter.
Asthma Action Plan: Develop and follow a written asthma action plan with your doctor.
Flu and Pneumonia Vaccines: Get vaccinated annually to reduce the risk of respiratory infections.
Manage Comorbidities: Address underlying conditions like nasal polyps or GERD.
How long does an outbreak last?
The duration of an asthma exacerbation (flare-up) varies. Mild exacerbations may resolve within a few hours or days with appropriate treatment. Severe exacerbations can last for several days or weeks and may require hospitalization. The goal of long-term management is to minimize the frequency and severity of outbreaks.
How is it diagnosed?
Diagnosis typically involves:
Medical History and Physical Exam: Assessment of symptoms and risk factors.
Pulmonary Function Tests (PFTs): Spirometry to measure lung function.
Sputum Analysis: Examination of sputum to identify eosinophils.
Blood Tests: Complete blood count (CBC) to measure eosinophil levels.
Allergy Testing: To identify potential triggers.
Imaging Studies: Chest X-ray or CT scan to rule out other conditions.
Fractional Exhaled Nitric Oxide (FeNO) Test: To measure airway inflammation.
Timeline of Symptoms
The onset and progression of eosinophilic asthma symptoms can vary. It can develop gradually over time, or it can present as sudden, severe exacerbations.
Early Stages: Mild wheezing, coughing, or shortness of breath, often mistaken for a common cold.
Progression: Symptoms become more frequent and severe, with increased mucus production and chest tightness.
Exacerbations: Sudden worsening of symptoms, requiring prompt treatment.
Chronic Stage: Persistent inflammation leads to long-term airway damage and reduced lung function if not adequately controlled.
Important Considerations
Personalized Treatment: Management should be tailored to individual needs and response to medications.
Regular Monitoring: Ongoing assessment of symptoms, lung function, and eosinophil levels is crucial.
Specialist Care: Consultation with a pulmonologist or allergist is recommended.
Patient Education: Understanding the condition and treatment plan is essential for effective self-management.
Adherence to treatment: Consistent adherence to prescribed medication is vital for disease control and preventing severe exacerbations.
Comorbidities: Management of co-existing conditions such as nasal polyps, sinusitis or GERD is crucial to improve asthma control.