Dr Michael E. Weschler: Differentiating Eosinophilic Asthma From Other Eosinophilic Conditions

Michael E. Wechsler, MD, a pulmonologist at National Jewish Health, discusses the challenges associated with differentiating similar eosinophilic conditions, including eosinophilic asthma, from one another.

Transcript

What are some of the challenges with distinguishing eosinophilic asthma from other diagnoses associated with abnormal eosinophil activity?

Well, you have to recognize that eosinophils are involved, and you can do that easily by evaluating the number of eosinophils in the blood. And so, with any disease state, you want to look for eosinophils at or in the tissue. And there aren't major challenges in terms of distinguishing from other eosinophilic conditions, other than the fact that there can be some overlap between the different conditions.

So for instance, there's eosinophilic asthma, that's basically just airway disease with eosinophils in the blood and/or the airway. Then, there's an entity called chronic eosinophilic pneumonia, which is basically eosinophilic asthma with some chronic sinus disease and pulmonary infiltrates. And then there is an entity called EGPA, or eosinophilic granulomatosis with polyangiitis. And that's an entity that's characterized by asthma, eosinophilia, sinus disease, pulmonary infiltrates, and then vasculitis in 1 or more end organ, including in neuropathy. And lastly, there are hypereosinophilic syndromes, which aren't really associated with asthma but have eosinophilia and organ involvement in systemic manifestations.