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Association of the blood eosinophil count with end-organ symptoms
INTRODUCTION: Eosinophilia may cause organ dysfunction, but an exact relation between eosinophil blood counts and adverse outcomes has not been described. The aim of the study is to associate in one model both normal and increased blood eosinophil counts to the subsequent development of common condi...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6637252/ https://www.ncbi.nlm.nih.gov/pubmed/31360453 http://dx.doi.org/10.1016/j.amsu.2019.06.015 |
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author | Bjerrum, Ole Weis Siersma, Volkert Hasselbalch, Hans Carl Lind, Bent Andersen, Christen Lykkegaard |
author_facet | Bjerrum, Ole Weis Siersma, Volkert Hasselbalch, Hans Carl Lind, Bent Andersen, Christen Lykkegaard |
author_sort | Bjerrum, Ole Weis |
collection | PubMed |
description | INTRODUCTION: Eosinophilia may cause organ dysfunction, but an exact relation between eosinophil blood counts and adverse outcomes has not been described. The aim of the study is to associate in one model both normal and increased blood eosinophil counts to the subsequent development of common conditions in internal medicine, in which eosinophil granulocytes may play a role for the symptoms. METHODS: From the Copenhagen Primary Care Differential Count (CopDiff) Database, we identified 359,950 individuals with at least one differential cell count (DIFF) during 2000–2007. From these, one DIFF was randomly chosen. From the Danish National Patient Register we ascertained organ damage, within four years following the DIFF. Using multivariable logistic regression, odds ratios were calculated and adjusted for previous eosinophilia, sex, age, year, month, CRP and comorbid conditions. RESULTS: Risks for skin- and respiratory disease were increased from above the median eosinophil count of 0.16 × 10(9)/l and reached a plateau around 1.0 × 10(9)/l. Furthermore, risks of most outcomes also increased when the eosinophil count approached zero. CONCLUSIONS: The observed U-shaped association with a plateau of risks around 1 × 10(9)/l indicates that the risk for symptoms due to eosinophilia do not increase proportionate at higher counts. This study demonstrates for the first time that there is indeed an increased risk below median count of 0.16 × 10(9)/l for an increased risk for the same manifestations. Clinically, it means that a normal or even low count of eosinophils do not rule out a risk for organ affection by eosinophils, and may contribute to explain, why patients may have normal eosinophil counts in e.g. asthma or allergy and still have symptoms from the lungs and skin, most likely explained by the extravasation of eosinophils. |
format | Online Article Text |
id | pubmed-6637252 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-66372522019-07-29 Association of the blood eosinophil count with end-organ symptoms Bjerrum, Ole Weis Siersma, Volkert Hasselbalch, Hans Carl Lind, Bent Andersen, Christen Lykkegaard Ann Med Surg (Lond) Original Research INTRODUCTION: Eosinophilia may cause organ dysfunction, but an exact relation between eosinophil blood counts and adverse outcomes has not been described. The aim of the study is to associate in one model both normal and increased blood eosinophil counts to the subsequent development of common conditions in internal medicine, in which eosinophil granulocytes may play a role for the symptoms. METHODS: From the Copenhagen Primary Care Differential Count (CopDiff) Database, we identified 359,950 individuals with at least one differential cell count (DIFF) during 2000–2007. From these, one DIFF was randomly chosen. From the Danish National Patient Register we ascertained organ damage, within four years following the DIFF. Using multivariable logistic regression, odds ratios were calculated and adjusted for previous eosinophilia, sex, age, year, month, CRP and comorbid conditions. RESULTS: Risks for skin- and respiratory disease were increased from above the median eosinophil count of 0.16 × 10(9)/l and reached a plateau around 1.0 × 10(9)/l. Furthermore, risks of most outcomes also increased when the eosinophil count approached zero. CONCLUSIONS: The observed U-shaped association with a plateau of risks around 1 × 10(9)/l indicates that the risk for symptoms due to eosinophilia do not increase proportionate at higher counts. This study demonstrates for the first time that there is indeed an increased risk below median count of 0.16 × 10(9)/l for an increased risk for the same manifestations. Clinically, it means that a normal or even low count of eosinophils do not rule out a risk for organ affection by eosinophils, and may contribute to explain, why patients may have normal eosinophil counts in e.g. asthma or allergy and still have symptoms from the lungs and skin, most likely explained by the extravasation of eosinophils. Elsevier 2019-07-09 /pmc/articles/PMC6637252/ /pubmed/31360453 http://dx.doi.org/10.1016/j.amsu.2019.06.015 Text en © 2019 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Original Research Bjerrum, Ole Weis Siersma, Volkert Hasselbalch, Hans Carl Lind, Bent Andersen, Christen Lykkegaard Association of the blood eosinophil count with end-organ symptoms |
title | Association of the blood eosinophil count with end-organ symptoms |
title_full | Association of the blood eosinophil count with end-organ symptoms |
title_fullStr | Association of the blood eosinophil count with end-organ symptoms |
title_full_unstemmed | Association of the blood eosinophil count with end-organ symptoms |
title_short | Association of the blood eosinophil count with end-organ symptoms |
title_sort | association of the blood eosinophil count with end-organ symptoms |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6637252/ https://www.ncbi.nlm.nih.gov/pubmed/31360453 http://dx.doi.org/10.1016/j.amsu.2019.06.015 |
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