Reasons for low direct count of eosinophils

The low direct count of eosinophils may be caused by physiological factors such as glucocorticoid use, circadian rhythm changes, or pathological factors such as acute infection or Cushing's syndrome, and should be judged comprehensively based on clinical manifestations and laboratory tests.

1. Corticosteroid effects:

Elevated exogenous or endogenous glucocorticoids can inhibit the release of eosinophils from the bone marrow. Long term use of glucocorticoids such as prednisone and hyperfunction of the adrenal cortex can lead to a decrease in eosinophils. These changes are usually accompanied by Cushing's syndrome symptoms such as full moon face and centripetal obesity, and the values can gradually recover after discontinuing medication or controlling the primary disease.

2. Diurnal Rhythm fluctuations:

Eosinophil counts exhibit physiological diurnal variations, with values decreasing by approximately 20% -30% from afternoon to night compared to morning. This fluctuation is related to the rhythm of cortisol secretion in the human body and is a normal physiological phenomenon that does not require special treatment. It is recommended to collect blood samples for re examination between 8-10 am.

3. Acute stress response: Under severe trauma, burns, acute myocardial infarction and other stress states, the body inhibits eosinophil release through neuroendocrine regulation. After the elimination of the stressor, the values can naturally rebound 2-3 days later, which may be accompanied by changes in blood parameters such as an increase in neutrophils and a decrease in lymphocytes.

4. Acute phase of bacterial infection: During acute infections such as Streptococcus pyogenes and Staphylococcus aureus, inflammatory mediators can inhibit eosinophil production. Patients often experience fever, elevated C-reactive protein, and significant increase in neutrophils on blood routine. After one week of effective anti infection treatment, eosinophil count can return to normal.

5. Bone marrow suppressive diseases: When diseases such as aplastic anemia and myelodysplastic syndrome lead to a decrease in whole blood cells, eosinophils often decrease synchronously. This type of situation is often accompanied by anemia and bleeding tendency. Bone marrow puncture examination shows a significant decrease in hematopoietic cells, and immunosuppressive or hematopoietic stem cell transplantation treatment is needed for the primary disease.

It is recommended to maintain a regular daily routine, avoid staying up late, and reduce unnecessary use of glucocorticoids. During acute infection, pay attention to monitoring changes in blood routine, and complete bone marrow examination is necessary when symptoms such as anemia and bleeding continue to occur due to decreased eosinophils. In terms of diet, it is advisable to moderately increase animal liver and fish rich in vitamin B12, as well as iron rich red meat, spinach, etc., but it is necessary to avoid blindly taking blood supplements to avoid interfering with the diagnosis of the disease.