Is an eosinophil count of 582 considered high?

Assessment of Eosinophil Count of 582

An eosinophil count of 582 cells/μL is considered mild eosinophilia, as it exceeds the normal threshold of 500 cells/μL defined by clinical guidelines. 1

Classification of Eosinophilia

According to current guidelines, eosinophilia is classified as:

• Normal range: <500 cells/μL
• Mild eosinophilia: >500 cells/μL
• Moderate eosinophilia: >1,500 cells/μL
• Severe eosinophilia: >5,000 cells/μL 1

At 582 cells/μL, this value falls into the mild eosinophilia category, just above the normal threshold.

Clinical Significance

Mild eosinophilia of this level warrants attention but is not typically associated with immediate organ damage. The clinical significance depends on:

• Duration of the eosinophilia
• Associated symptoms
• Underlying cause

Common Causes of Mild Eosinophilia

1. Allergic conditions:

   • Allergic rhinitis
   • Asthma
   • Atopic dermatitis

2. Parasitic infections:

   • Particularly relevant in travelers or those with exposure history
   • Helminth infections are the most common worldwide cause 2

3. Medication reactions:

   • Various drugs can cause mild eosinophilia

4. Other causes:

   • Autoimmune disorders
   • Connective tissue diseases
   • Early stages of more serious conditions

Recommended Approach

For a patient with an eosinophil count of 582 cells/μL:

1. Confirm persistence:

   • Repeat CBC to verify the finding is not transient 1

2. Detailed history focusing on:

   • Travel to tropical/subtropical areas
   • Exposure to freshwater
   • Raw food consumption
   • Recent medication changes
   • Allergy history 1

3. Initial laboratory evaluation:

   • Complete blood count with differential
   • Peripheral blood smear
   • Comprehensive metabolic panel with liver function tests
   • Urinalysis with protein-to-creatinine ratio 1

4. Consider parasitic evaluation if clinically indicated:

   • Microscopic examination of stool samples (3 samples)
   • Serological tests based on geographical exposure 1

Monitoring and Follow-up

• For mild eosinophilia like 582 cells/μL:
  • Regular monitoring with follow-up CBC is recommended to confirm resolution or progression 1
  • If persistent (>3 months), closer monitoring for potential end-organ damage may be warranted

Important Considerations

• While this level of eosinophilia is mild, persistent elevation even at this level should not be ignored
• Mild eosinophilia rarely requires immediate intervention but does warrant investigation to determine the underlying cause
• If the eosinophil count increases over time or remains persistently elevated, more comprehensive evaluation may be necessary

In summary, an eosinophil count of 582 cells/μL represents mild eosinophilia that requires clinical correlation and appropriate follow-up, but is not considered severely elevated.