1. < MAC & Bronchiectasis

bronchiectasis and high eosinophil count

Posted by @ling @wangling, Nov 6, 2022

Hi community,
I am recently diagnosed with bronchiectasis. I feel so lucky that I found this forum with wonderful people to share your experiences. I already feel the hope. Thank you all for being here to help out.
Does anyone have the expereince that bronchiectasis could cause a high eosinophil count?
Many thanks in advance!
Ling

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@ling | @wangling | Nov 9, 2022

Thank you Bippus for your reply. I  am so sorry to hear  that you got the MAC again. Will you be on antibiotics again?
It is alway comforting to hear how other people are dealing  with the same problems. Sounds like since 2013 you have been successfully managing the disease and living a normal life. To me it is really a big deal.
I felt the sky was falling until I found this community, this community gives me hope.
Thank you again and I hope you find the right doctor to work with.
.Ling

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sue102 | @sue102 | Nov 10, 2022

Gloria, I’m so sorry to learn that you got MAC back. I am now on the 3 meds, but have not turned the sputum culture negative yet. Hopefully soon. Patients on this forum have talked about remission but not cure for NTM. Does that mean that a reinfection is inevitable?
I have a few questions for you if you don’t mind answering all or any of them. We could learn from your experience.
1. What measures did you take to reduce your exposure to MAC during the 8-year remission?
2. Were you doing airway clearance with hypertonic saline solution at least once daily during remission?
3. What symptoms did you have that indicted a return of the infection?
4. How often were you getting tested for MAC?

Wishing you all the luck in finding a knowledgeable team of medical experts in NTM. Try to find a large research institution with NTM department in your state.
All the best.

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hcroom | @hcroom | Nov 11, 2022

I have had asthma with a double-digit eosinophil count for 60 years. I was diagnosed with bronchiectasis about 20 years ago. This seems the reverse of your experience.

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1 reply
@ling | @wangling | Nov 12, 2022
In reply to @hcroom "I have had asthma with a double-digit eosinophil count for 60 years. I was diagnosed with..." + (show)
@hcroom

I have had asthma with a double-digit eosinophil count for 60 years. I was diagnosed with bronchiectasis about 20 years ago. This seems the reverse of your experience.

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Hi @hcroom
Thank you. My pulmonologist said the other day that it is likely my high eosinophil count causes bronchiectasis. Your 60 years of dealing with high eosinophil count and 20 years of bronchiectasis, what a successful story. My pulmonologist said there is a new drug very effective for treating eosinophil count, it is called "IL4/IL5 inhibitor". Have you tried it?
Does your bronchiectasis condition get worse over the years or stay stable?
Best and be safe!
Ling

REPLY
1 reply
hcroom | @hcroom | Nov 12, 2022
In reply to @wangling "Hi @hcroom Thank you. My pulmonologist said the other day that it is likely my high..." + (show)
@wangling

Hi @hcroom
Thank you. My pulmonologist said the other day that it is likely my high eosinophil count causes bronchiectasis. Your 60 years of dealing with high eosinophil count and 20 years of bronchiectasis, what a successful story. My pulmonologist said there is a new drug very effective for treating eosinophil count, it is called "IL4/IL5 inhibitor". Have you tried it?
Does your bronchiectasis condition get worse over the years or stay stable?
Best and be safe!
Ling

Jump to this post

I tried Fasenra which contains a monoclonal antibody directed against the alpha chain of the interleukin 5 (IL5) receptor. My eosinophil count dropped to zero!
After three years I decided the cost- benefit analysis didn't justify continuing this medication. I am sure there will be many meds directed against the action of these interleukins. The primary literature has shown already that some are more efficacious than others. All are expensive, even if insurance pays some of the cost.

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1 reply
@ling | @wangling | Nov 12, 2022
In reply to @hcroom "I tried Fasenra which contains a monoclonal antibody directed against the alpha chain of the interleukin..." + (show)
@hcroom

I tried Fasenra which contains a monoclonal antibody directed against the alpha chain of the interleukin 5 (IL5) receptor. My eosinophil count dropped to zero!
After three years I decided the cost- benefit analysis didn't justify continuing this medication. I am sure there will be many meds directed against the action of these interleukins. The primary literature has shown already that some are more efficacious than others. All are expensive, even if insurance pays some of the cost.

Jump to this post

That is good you are on top of it, the drug was out in 2018. Yes, it is very expensive.
Take care and best luck to you!

Ling

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Mentor
Terri Martin, Volunteer Mentor | @windwalker | Nov 14, 2022
In reply to @wangling "Hi Sue, Thank you so much for your reply and thank you for being the voluntary monitor for..." + (show)
@wangling

Hi Sue,
Thank you so much for your reply and thank you for being the voluntary monitor for this group to offer help and hope which is very comforting to me.
Last Oct.  I started coughing, especially bad at night. I went to see 4 different  doctors, they could  not identify anything wrong, x-ray showed nothing.  The coughing never  went away and in Feb. this year I got pneumonia. During  pneumonia treatment,  they did a wide range of blood tests and lung function tests. The function test was normal and a CT scan in March showed pneumonia.  But cough mucus never went away, because of all the test results, doctors believe that I was healing slowly from pneumonia. But recently my condition got worse. I was out of breath while walking. And I got so much more mucus. So they did another CT scan.  This time,  it came with the bad news, I had infections in my lungs and mild bronchiectasis. I have not done another test to identify NTM yet. I might need it in the future. As you all know bronchiectasis is not going to kill us right away, but it makes us so susceptible to infections which is scary. I was so happy to  find you, living a normal life with this disease. This means so much to me. I feel like this is a new family I belong to. In this family we help one another, encourage one another and give advice to one another, and give hope to one another. Right now I am still gathering information on how to control my bronchiectasis condition and try to live a normal life as you all do.My pulmonologist asked me to use the albuterol twice a day before I use a mucus device to get mucus out. Reading your posts,  it seems that keeping the airway clean is the key to avoiding  infections, is that right?  It seems you all use Nebulised 7% hypertonic saline. And some people use smartvest. Should I start using them? I read your earlier post, you mentioned finding a bronchiectasis specialist to work with is very important. I think it is a good idea. I found a pulmonologist focusing on bronchiectasis. I will try to get an appointment with him and see what he says. But you live with this disease and know what works and what not.  I truly value your opinions. Please let me know what you think I should do at my stage. I want to live a normal life, a full life like you say.  Many thanks agaiin!
Ling

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Good morning Ling. I did not see a mention of a sputem test in your post. Did you have that done as well?

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1 reply
@ling | @wangling | Nov 14, 2022
In reply to @windwalker "Good morning Ling. I did not see a mention of a sputem test in your post...." + (show)
@windwalker

Good morning Ling. I did not see a mention of a sputem test in your post. Did you have that done as well?

Jump to this post

Hi Terri,
Thanks for asking. My CT scan shows that I have bronchiectasis. Then I did the "SPUTUM CYSTIC FIBROSIS" test. I had two different bacteria infections. I took antibiotics to treat them.
Do you mean the sputum test can also show if I have bronchiectasis?
Ling

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bsi15 | @bsi15 | Aug 14 4:44am

apparently there was some research in the last few years for this.
20% of BE is eosinophilic and its more severe than average BE.
They call it a new endotype now.
Some (most) recommend to treat it with inhaled corticosteroides (IC).
They compare it with asthma, but while IC usually works in asthma,
it doesn't work in eosinophilic asthma.
And there are some side effects with IC.

I have BE and usually high eosinophiles but dominant neutrophiles
on my pneumonia and some earlier undiagnosed infection.
The lab here measures eosinophiles in % of all leucocytes, not counts per myl.

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