What is Basophilia?
Basophils are a type of white blood cell, usually found in small numbers in your blood. You can easily recognize them because they have a lot of dark-colored granules inside them. It’s rare to have too many basophils, a condition known as basophilia, in your blood. This usually happens as a response to something else in your body and often occurs along with another condition called eosinophilia. Then, basophil count exceeds 200 cells per microliter of blood. However, this range could vary depending on the laboratory and the local population.
If necessary, a bone marrow aspiration, which is a test that examines bone marrow, might show an increase in basophils or their precursor cells. Basophils are known to show certain markers termed CD45, CD13, CD11b, and CD33. They also express CD22, which is also found in B-cells, another type of white blood cells, and have a high level of CD38 and CD123 markers.
What Causes Basophilia?
Increased levels of a type of white blood cell called basophils could indicate a possible underlying cancer like chronic myeloid leukemia, polycythemia vera, primary myelofibrosis, essential thrombocythemia, acute myeloid leukemia, or even some solid tumors. Common reasons for this increase include allergic reactions or chronic inflammation due to infections such as the flu and tuberculosis, inflammatory bowel disease, and autoimmune diseases. Use of certain medications and the consumption of some foods can also be linked with symptoms and an increase in basophils.
Risk Factors and Frequency for Basophilia
Basophilia is a condition that affects both men and women evenly. However, how often it occurs can vary based on the underlying cause.
Signs and Symptoms of Basophilia
Basophilia is a condition related to an underlying cause, which can have a variety of symptoms. For instance, if the spleen is unusually large, a condition where the bone marrow creates too many cells may be suspected. The individual may have widespread symptoms such as fever, tiredness, itching, and a general feeling of being unwell. They may also feel pain in the upper right part of the belly. If the person has a condition called polycythemia vera, they might experience a burning sensation in their hands and feet. Some people with basophilia may also feel itchy after a warm shower.
- Spleen unusually large
- Fever
- Tiredness
- Itching
- General feeling of being unwell
- Pain in the upper right part of the belly
- Burning sensation in the hands and feet (in case of polycythemia vera)
- Itchy skin after warm shower
Worrying symptoms include skin rashes and the formation of blood clots. These tend to appear when the condition is quite serious. To check for a large spleen, the person should lie down and relax their stomach. The healthcare professional will try to insert three fingers into the space under the left side of the rib cage while the person breathes in. This check can also be done using ultrasound. Hitch eosinophilic syndrome might be considered if there are more than 1500 eosinophilia cells per microliter. Symptoms and other body-wide signs are linked to the skin or lungs being involved.
Testing for Basophilia
The next step involves looking closely at a sample of your blood. This is called a peripheral blood smear and evaluation. If your doctor notices a higher than normal level of certain white blood cells and basophils, a type of white blood cell, they may recommend cytogenetic testing to rule out Chronic Myeloid Leukemia (CML). This involves looking for the presence of a specific genetic mutation known as BCR-ABL1, which, if present, supports the diagnosis of CML.
The other major types of blood disorders, such as Polycythemia Vera (PV), Primary Myelofibrosis (PMF), and Essential Thrombocythemia (ET), often carry genetic mutations. For example, most patients with PV have a mutation called Janus kinase 2 (JAK2). More than half of patients with primary myelofibrosis and essential thrombocythemia carry this mutation. However, a small number of patients with ET or PMF have mutations in genes called CALR or MPL. If one of these mutations is found, it doesn’t definitively mean you have a blood disorder; doctors need to look at the cells’ appearance and your symptoms too.
If your doctor decides to do a bone marrow biopsy because they suspect a disorder in your myeloid cells (a type of white blood cell), they will need to do genetic testing on your white blood cells. This involves looking at the structure of your chromosomes, which can reveal abnormal patterns that suggest a blood disorder. This same genetic testing can be done to quickly identify the BCR-ABL fusion in suspected CML cases.
Treatment Options for Basophilia
The suitable treatment will be based on what’s causing the problem. If the symptoms are related to allergies or chronic (long-term) inflammation, it’s crucial to tackle these underlying issues. For allergies, this usually means stopping any contact with whatever is triggering the allergic reaction and taking antihistamines, which are medicines made to combat allergy symptoms. If a parasitic infection is at the root, medication like albendazole is commonly used. It’s also worth mentioning that if the problem is related to abnormal tissue growth (neoplasia), the treatment would be more complex and isn’t covered in this discussion.
What else can Basophilia be?
“Toxic neutrophils” are a type of white blood cell that may contain small, stainable particles called “azurophilic granules”. Sometimes, they are confused with another type of white blood cell called “basophils”. However, the particles found in neutrophils are usually much smaller than those in basophils. Additionally, neutrophils often have other accompanying features, specifically Dohle bodies, which aren’t found in basophils.
What to expect with Basophilia
Basophilia generally has a good outlook, which can vary depending on the cause. If it is related to an infection, antibiotics would be administered to treat the root cause. Basophilia related to abnormal growths will have a more complicated medical journey. Chronic myeloid leukemia (CML) is usually treated with specialized drugs like imatinib, among other approaches.
Polycythemia vera (PV) and essential thrombocythemia (ET) are typically treated with aspirin therapy and periodic bloodletting. The overall survival for such patients is dependent on the quality of care, regular follow-up visits, and prevention strategies against blood-clot related complications.
Possible Complications When Diagnosed with Basophilia
The problems that come with basophilia, a condition in which there are too many basophils (a type of white blood cell) in the body, are not caused as much by the excess basophils themselves, but are usually linked to the underlying condition that caused the increase in basophils. However, the basophils can also damage new tissues if they release substances they contain, known as degranulating. Therefore, early steps to prevent such damage are crucial. Another potential complication of basophilia could be related to conditions like Chronic Myeloid Leukemia (CML), Polycythemia Vera (PV), or Essential Thrombocythemia (ET). These can lead to the formation of blood clots in arteries and veins. It is important that patients with these conditions should be sufficiently screened and take preventive actions to avoid such complications.
Complications of Basophilia:
- Damage to new tissues
- Blood clots in arteries and veins
- Associated complications from conditions like Chronic Myeloid Leukemia, Polycythemia Vera, or Essential Thrombocythemia