ELEVATED BLOOD EOSINOPHIL COUNT IS A MARKER OF SEVERE EXACERBATION IF BRONCHIECTASIS

Abstract

Purpose: This study aimed to differentiate between the clinical phenotypes of eosinophilic bronchiectasis (EB) and non-eosinophilic bronchiectasis (NEB) in patients with non-cystic fibrosis bronchiectasis.

 Study design: A retrospective study

 Place of the Study: The study was conducted at Department of pulmonology Jinnah Postgraduate Medical Center Karachi  From 05- April 2023 To 05-April 2024.

 Methods and Materials: Seventy-five patients with acute exacerbations of non-cystic fibrosis bronchiectasis were included based on European Respiratory Society guidelines. Clinical data, including blood eosinophil levels, were collected retrospectively. Patients were categorized into EB (blood eosinophil count ≥ 300 cells/µl) and NEB (blood eosinophil count < 300 cells/µl) groups. Statistical analyses were performed using SPSS version 27.

 Results: Among 72 eligible patients, EB was identified in 6 cases. The EB group exhibited higher smoking index, male predominance, more severe bronchiectasis, decreased lung function, increased glucocorticoid use, and worse BSI and E-FACED scores compared to NEB group. EB patients also had higher prevalence of chronic rhinosinusitis, elevated serum total IgE levels, and increased HS-CRP levels. NEB group showed higher neutrophil percentage. No significant differences were observed in age, BMI, illness duration, Pseudomonas aeruginosa infection rate, or FeNO levels. EB group had lower NTM infection rates but incurred higher hospitalization costs. Higher blood eosinophil counts correlated with more severe bronchiectasis.

 Conclusion: we compare the clinical characteristic of eosinophilic bronchiectasis (EB) to that of non-eosinophilic bronchiectasis (NEB) in patients with non-cystic fibrosis bronchiectasis. Patients with EB had significantly poorer lung function, higher BSI and E-FACED scores and more extensive disease on CT scan. Furthermore, EB patients incurred higher hospitalization charges, and more comorbid conditions, including chronic rhinosinusitis and high serum IgE, indicating an allergic disposition.