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Assessing Therapeutic Response in Allergy by Eosinophil Count

Dr. Arup Das, Dr. Subhash Chaudhary and Dr. D. Basu

Since eosinophil counts have relation with allergy, it is possible for the homoeopathic physician undertaking treatment for allergy to monitor the progress of the patients of allergy by doing eosinophil count from time to time. This simple and cheap procedure will help not just monitoring but also laboratory evidence for documentation of response of allergic diseases to homoeopathic treatment.


Introduction

The term allergy commonly refers to describe an adverse reaction to food, drug or any other substance whereas to clinician it refers to specific antibody mediated reactions to allergens. Physicians have to encounter this problem quite often in clinical practice. Homoeopathic physicians have to deal with large number of such cases which often required prolonged treatment with encouraging results. There are many modern investigations recommended for diagnosis but eosinophil count in blood can be helpful for diagnosis as well as to monitor the response to the treatment.

Allergy

The concept of “allergy” was originally introduced in 1905 by Clemens von Pirquet, after noting hypersensitiveness to normally innocuous entities such as dust, pollen, or certain foods in some patients [1]. In 1963, a new classification for hypersensitivity was designed by Robin Coombs and Philip Gell that described four types of hypersensitivity reactions. With this new classification, the word “allergy” was restricted to type I hypersensitivity (also known as immediate hypersensitivity), characterized by rapidly developing reactions. The mechanism of allergy was better understood after the discovery of the antibody immunoglobulin E (IgE) by Kimishige Ishizaka in 1960s

Role of Eosinophils in Allergy

Hypersensitivity reaction has an early or acute phase of reaction which is commonly mediated by basophils, immunoglobulin E and various inflammatory chemical mediators such as histamine, cytokines, interleukins, leukotrienes and prostaglandins. After the chemical mediators of the acute response subside, late phase responses occur. This is due to the migration of other leukocytes such as neutrophils, lymphocytes, eosinophils and macrophages to the initial site. Eosinophils are mainly recruited by the activated eosinophilic chemotactic factor. The reaction is usually seen 2–24 hours after the original reaction. Late phase responses seen in asthma are slightly different from those seen in other allergic responses, although they are still caused by release of mediators from eosinophils. So eosinophils are more important and common findings in the late phase allergic reaction. This is the cause of peripheral eosinophilia occurring in the patients suffering from allergy.

Clinical Manifestations

Airborne allergens like dust or pollen often affect eyes, nose, and lungs. This may result in allergic rhinitis or hay fever, characterized by irritation of the nose, sneezing, coryza and redness of the eyes. Inhaled allergens can also produce asthmatic symptoms like shortness of breath, cough and wheezing. Allergic reactions can also result from different foods, insect stings, and reactions to several drugs. Symptoms of food allergy may include abdominal pain, vomiting, diarrhoea, itching and swelling of the skin during urticaria but respiratory reactions are rare. Insect stings and various drugs can produce systemic anaphylaxis; which if severe can cause death.

History is vital to diagnose allergy and to distinguish from non-allergic reactions, as this will affect decisions regarding further investigation and management.

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