Interpretation of CBC Results: Eosinophil 0.86 and Basophil 0.10
Normal Range Assessment
Your eosinophil count of 0.86 × 10⁹/L is elevated above the upper limit of normal (0.45 × 10⁹/L), while your basophil count of 0.10 × 10⁹/L falls within the normal range. 1
Clinical Significance of Your Results
Eosinophil Elevation (0.86 × 10⁹/L)
Your eosinophil level represents mild eosinophilia, falling between the normal upper limit (0.45 × 10⁹/L) and the threshold for hypereosinophilia (1.5 × 10⁹/L). 1
At this level (0.75-1.0 × 10⁹/L range), there is a more than twofold increased risk of hematological malignancies, though this risk plateaus around 1.0 × 10⁹/L. 2
Eosinophil counts in this range are commonly associated with parasitic infections (particularly in travelers from tropical regions), allergic conditions, drug reactions, or eosinophilic tissue disorders. 3, 1
Basophil Level (0.10 × 10⁹/L)
- Your basophil count is normal and requires no specific evaluation. Normal basophil levels effectively exclude basophilic crisis or mixed-lineage hematological disorders. 4
Recommended Diagnostic Workup
Initial Clinical Assessment
Evaluate for travel history to tropical/subtropical regions within the past several years, as helminth infections are the most common cause of mild eosinophilia in this context. 3, 1
Assess for allergic conditions including asthma, allergic rhinitis, atopic dermatitis, and food allergies, which are present in 50-80% of patients with eosinophilic disorders. 3
Review all current medications and supplements to identify potential drug-induced eosinophilia. 3
Inquire about gastrointestinal symptoms (dysphagia, food impaction, abdominal pain) that may suggest eosinophilic esophagitis, which occurs with peripheral eosinophilia in 10-50% of adults. 3, 1
Laboratory and Diagnostic Testing
Obtain stool microscopy for ova and parasites (three separate samples) and consider serology for specific helminth infections based on travel exposure. 3
Repeat eosinophil count in 1 month to determine if elevation is persistent, as hypereosinophilia is formally defined as >1.5 × 10⁹/L on two examinations at least one month apart. 1
If gastrointestinal symptoms are present, perform upper endoscopy with six biopsies from at least two different esophageal sites to evaluate for eosinophilic esophagitis (diagnostic threshold: >15 eosinophils per 0.3 mm²). 5, 3
Treatment Considerations
For Parasitic Infections (if identified)
Albendazole 400 mg single dose for most helminth infections. 3
Ivermectin 200 μg/kg single dose for strongyloidiasis. 3
For asymptomatic returning travelers with eosinophilia, empiric treatment with both albendazole 400 mg plus ivermectin 200 μg/kg may be considered. 3
For Allergic Conditions
- Optimize treatment of underlying atopic diseases (asthma, allergic rhinitis, atopic dermatitis) as these can contribute to peripheral eosinophilia. 3
Important Clinical Caveats
Eosinophil counts show substantial variability with seasonal differences of approximately 20% between summer and winter months, and single measurements may not be sufficient for diagnosis. 6
Nasal polyps increase eosinophil levels by 38%, while current smoking decreases levels by 23%. 6
Blood eosinophil levels do not always correlate with tissue eosinophilia in conditions like eosinophilic esophagitis, so tissue diagnosis may be necessary despite modest peripheral eosinophilia. 3
Eosinophil counts between 0.5-1.0 × 10⁹/L warrant investigation even though they fall below the formal definition of hypereosinophilia, as risks of underlying pathology are still elevated. 2