QuestionHello,
I have an important issue so I am hoping someone well-versed in reproductive endocrinology can assist.
I recently confirmed pregnancy. My cbc came back with Eosinophils at 7. My dr. Said they treat anything at a "2" and over with Prednisone. They said left untreated that it causes a risk of early miscarriage.
My last cbc in April showed Eos at 1.5 which is normal. I have not have a chronic issue with elevated eosinophils.
I have an autoimmune blood disorder called APS and am asymptomatic except for during pregnancy where I must be treated with Lovenox. This is my first pregnancy on the drug.
To get pregnant this time, I used 3 days worth of generic Menapur (HMG). I developed welts that hurt and then itched as they healed. The last shot was 19 days ago.
I am wondering if the allergic reaction I had to the HMG shots would have caused the elevation in Eosinophils.
I am NOT AT ALL comfortable taking steroids during pregnancy. I fear that if this level should get elevated again that they will recommend that I go off and on Prednisone. I want a natural alternative OR to simply be at peace that the EOS will not effect my pregnancy since many women have allergies, hay fever etc while pregnant and I am not aware that they are all put on steroids if their EOS are higher. Or if this is even checked.
I will not throw drugs at everything if it isn't emergent.
Please give me your opinion on this dilemma. Is there a risk that my body will reject the embryo if I don't lower the Eosinophils in my blood?? That is the most important part of this question. DOES THE HIGH EOSINOPHILS POSE A RISK OF MISCARRIAGE?
Thanks for the advice!
AnswerEosinophilia, with or without pregnancy needs be evaluated in detail. When you mention that your blood eosinophil count is 7, i assume it to be 700 cells/microlit. This would be classified as mild eosinophilia.
Now let us consider the possibilities.
1. You could be suffering from a allergic reaction to HMG as you mentioned. Since you are mentioning a history of welts and itching, allergy is top on the list. Did you develop these welts immediately after the first dose or was it later.If this was due to allergy, then it is likely to subside on its own. A repeat CBC after four weeks should clear the diagnosis.
2. You mentioned that you were suffering from APS, many autoimmune and connective tissue disorders are associated with increased eosinophil counts. But the strength of association is quite limited. Therefore this is a possibility, albeit with a lesser chance.
3.Levonox itself is known to cause allergic reactions and symptoms similar to hay fever. Therefore this is also a possibility.
In my opinion, there is no requirement to treat your eosinophilia with steroids. You have mildly raised eosinophills, are presently asymptomatic, and do not have any end organ involvement. Apart from this, I have done an extensive search of all medical literature available and I could not get any causative evidence of eosinophilia causing miscarriage. Therefore the best course of action would be to get regular CBC's done( once a month) and monitor the level of eosinophills.
Since eosinophilia tends to affect the heart and lungs preferentially, the following symptoms must serve as a warning: Breathlessness, chest tightness, dry cough, swelling of feet, chest pain, fatigue and exercise intolerance. There is no specific level at which treatment should be initiated. Treatment is initiated based on the clinical features of the patient and you surely do not require to go on steroids at least for now.
