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Symptoms of Eosinophilic Asthma

Posted on March 08, 2021
Medically reviewed by
Deborah Pedersen, M.D.
Article written by
Amanda Agazio, Ph.D.

  • Unlike other forms of asthma, eosinophilic asthma may affect the entire respiratory system — not just the lungs.
  • In addition to severe asthma attacks, people with eosinophilic asthma may develop chronic sinus issues, nasal polyps, and changes in lung function.
  • In some people with eosinophilic asthma, hypereosinophilic syndrome (HES) may cause fatigue, rashes, mouth sores, and cognitive symptoms such as confusion and memory loss.

Eosinophilic asthma is a severe form of asthma that may cause frequent and intense asthma attacks. Although eosinophilic asthma symptoms can differ from one person to the next, it’s important to know what to look for when it comes to this condition.

Eosinophilic asthma is characterized by high levels of white blood cells known as eosinophils in the blood and lungs. Eosinophils promote inflammation, which results in the tissue damage, mucus production, and hyperresponsive airways that lead to the symptoms of eosinophilic asthma.

Read more about the causes and diagnosis of eosinophilic asthma.

Shortness of Breath

In most types of asthma, the airways within the lungs become swollen and obstructed with mucus and fluid. This can lead to wheezing and difficulty breathing. But with eosinophilic asthma, the entire respiratory system — from the sinuses to the deepest part of the lungs — can become inflamed and obstructed. Therefore, people with eosinophilic asthma may experience serious symptoms like shortness of breath.

Wheezing

Although shortness of breath can be one of the predominant symptoms for individuals with eosinophilic asthma, wheezing is also common. Wheezing is due to inflammation and narrowing of the airways, which produces a high-pitched sound while breathing in and out. People who are wheezing may have rapid, difficult breathing patterns. If the wheezing is severe, they could have a bluish tint to their skin.

Coughing

Coughing is a common symptom for all forms of asthma. Asthma makes the lungs more sensitive to irritants or allergens, which can lead to coughing. For allergic asthma, cough triggers are often allergens like pet dander and pollen. But most individuals with eosinophilic asthma aren’t as sensitive to allergens and are often triggered by irritants. Stress, exercise, weather conditions, infections, fragrances, air pollution, and smoke are common irritants that can cause asthma symptoms.

Chest Tightness

People with all types of asthma may experience tightness in the chest, which can manifest in several ways. Some people say it feels like having a heavy weight on their chest, while others describe it as a dull pain or a sharp, piercing feeling.

There is some debate over where these sensations originate. Some researchers believe it has to do with the chest muscles, while others have suggested it has to do with the stimulation of the airway while breathing. Chest tightness may make it hard to take deep breaths and could even cause sharp pain.

Abnormal Lung Function

Many people with asthma will have abnormal lung function when their asthma is poorly controlled. Once asthma is well controlled, lung function tests should become normal. When left untreated, inflammation and damage to the lungs caused by eosinophilic asthma can lead to permanent thickening of basement membranes in the lungs. Thickened basement membranes can cause reduced lung function and poor airflow.

Lung function changes seen in eosinophilic asthma are similar to those in chronic obstructive pulmonary disorder (COPD). Eosinophilic asthma can sometimes be mistaken for COPD.

Chronic Rhinosinusitis

Chronic rhinosinusitis is an inflammatory condition that affects the sinuses. Rhinosinusitis is characterized by facial pain and pressure, lack of smell, congested nasal passages, and a runny nose. Some studies suggest chronic rhinosinusitis may be linked to eosinophil activity, and it’s possible that rhinitis and eosinophilic asthma have a shared cause.

Nasal Polyps

Nasal polyps are benign growths in the nasal passages or sinuses that may develop with chronic inflammation. Nasal polyps can vary in size, and larger polyps may be associated with symptoms such as difficulty breathing and loss of smell. Nasal polyps may occur with eosinophilic asthma and chronic rhinosinusitis.

Asthma Attacks

An asthma attack, or asthma exacerbation, can happen when a sudden onset and worsening of symptoms occur. The lung airways become even more swollen and inflamed. Mucus production can increase. The muscles surrounding the airway may also contract, causing the airway to narrow. People with eosinophilic asthma may require a quick-acting rescue inhaler during an asthma attack or may need to seek emergency medical services.

Hypereosinophilic Syndrome

Many eosinophilic asthma symptoms are related to high numbers of eosinophils. The term eosinophilia is used to describe elevated levels of eosinophils in the blood or tissues.

When eosinophil numbers reach excessive levels, a collection of symptoms known as hypereosinophilic syndrome (HES) can result. The tissues generally affected by HES include the lungs, heart, skin, and nervous system.

Symptoms associated with HES may include:

  • Dizziness
  • Confusion
  • Memory loss
  • Cough
  • Shortness of breath
  • Sores in the mouth
  • Rashes
  • Fatigue
  • Fever

Identifying Eosinophilic Asthma

Knowing the symptoms of eosinophilic asthma can help you determine if you or someone you know has this condition. Ultimately, a health care provider will need to make a diagnosis, which usually involves a test for eosinophil content in the blood or, occasionally, in the lung sputum. In severe cases, a physician may perform a bronchial biopsy or extract bronchial fluid from your lungs for evaluation.

Upon diagnosis, there are several treatment options for eosinophilic asthma. These include inhaled and oral corticosteroids and biologic monoclonal antibody therapies that target the inflammation pathways involved in eosinophilic asthma.

Read more about treatment options for eosinophilic asthma.

Talk With Others Who Understand

MyAsthmaTeam is the social network for people with asthma and their loved ones. On MyAsthmaTeam, more than 3,000 members come together to ask questions, give advice, and share their stories with others who understand life with asthma.

Are you living with eosinophilic asthma? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Deborah Pedersen, M.D. has specialized in allergy and asthma care as well as pediatrics for over 16 years. Review provided by VeriMed Healthcare Network. Learn more about her here.
Amanda Agazio, Ph.D. completed her doctorate in immunology at the University of Colorado Anschutz Medical Campus. Her studies focused on the antibody response and autoimmunity. Learn more about her here.

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