Das RR, Panigrahi MK, Mahapatro S, John J. Clinical and functional correlates of blood eosinophilia in pediatric asthma: A retrospective cohort study. World J Clin Pediatr 2026; 15(4): 122880 [DOI: 10.5409/wjcp.122880]
Corresponding Author of This Article
Rashmi Ranjan Das, MD, FCCP, Professor, Department of Pediatrics, All India Institute of Medical Sciences, Sijua, Patrapada, Bhubaneswar 751019, Odisha, India. ped_rashmi@aiimsbhubaneswar.edu.in
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Allergy
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Das RR, Panigrahi MK, Mahapatro S, John J. Clinical and functional correlates of blood eosinophilia in pediatric asthma: A retrospective cohort study. World J Clin Pediatr 2026; 15(4): 122880 [DOI: 10.5409/wjcp.122880]
World J Clin Pediatr. Dec 9, 2026; 15(4): 122880 Published online Dec 9, 2026. doi: 10.5409/wjcp.122880
Clinical and functional correlates of blood eosinophilia in pediatric asthma: A retrospective cohort study
Rashmi Ranjan Das, Manoj Kumar Panigrahi, Samarendra Mahapatro, Joseph John
Rashmi Ranjan Das, Samarendra Mahapatro, Joseph John, Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar 751019, Odisha, India
Manoj Kumar Panigrahi, Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar 751019, Odisha, India
Author contributions: Das RR, Mahapatro S, and John J contributed to the conceptualization and design; Das RR, Panigrahi MK, and John J contributed to material preparation, and data acquisition; Das RR, Panigrahi MK, and Mahapatro S, contributed to data analysis; and all authors contributed to writing-draft manuscript and writing-revision and approved to submit the final version.
AI contribution statement: AI tool (ChatGPT) was used solely for linguistic refinement and formatting assistance. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.
Institutional review board statement: The study was reviewed and approved by the Institutional Ethics Committee, All India Institute of Medical Sciences, Bhubaneswar [Approval No. T/IM-NF/Paedia/20/179; dated: February 8, 2021].
Informed consent statement: The requirement for informed consent was waived by the Institutional Ethics Committee owing to the retrospective nature of the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: There is no additional data available.
Corresponding author: Rashmi Ranjan Das, MD, FCCP, Professor, Department of Pediatrics, All India Institute of Medical Sciences, Sijua, Patrapada, Bhubaneswar 751019, Odisha, India. ped_rashmi@aiimsbhubaneswar.edu.in
Received: May 7, 2026 Revised: June 13, 2026 Accepted: June 26, 2026 Published online: December 9, 2026 Processing time: 141 Days and 16.5 Hours
Abstract
BACKGROUND
Pediatric asthma is a heterogeneous disease with distinct inflammatory phenotypes. Asthma with blood eosinophilia (driven by type 2 inflammation) is associated with increased asthma severity and poor asthma control. However, pediatric data including that from resource-limited settings [low-and-middle-income country (LMIC)] remains limited.
AIM
To evaluate the clinical characteristics, asthma severity, and lung function in children with asthma and blood eosinophilia from a LMIC setting.
METHODS
This retrospective cohort study included children aged 5-14 years with asthma evaluated at a tertiary care center in Eastern India between March 1, 2017 and February 29, 2020. Blood eosinophilia was defined as an absolute eosinophil count (AEC) of ≥ 400 cells/mm3. The primary outcome was the association between blood eosinophilia and asthma control. Secondary outcomes included asthma severity, spirometry parameters, serum immunoglobulin E (IgE) levels, and factors independently associated with eosinophilia. Clinical characteristics, asthma control test scores, lung function parameters, and serum IgE levels were compared between children with and without eosinophilia. Multivariate analysis was performed to identify factors independently associated with blood eosinophilia.
RESULTS
Among 176 children included in the analysis, 84 (47.8%) had blood eosinophilia. Poor asthma control was more common in children with eosinophilia than in those without eosinophilia (51.2% vs 34.8%, P = 0.027). Eosinophilia was significantly associated with moderate and severe asthma and with greater airway obstruction, reflected by a lower mean forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) ratio (65.5% vs 69.7%, P = 0.006). Median serum IgE levels were significantly increased in the eosinophilic group (295 vs 98 kIU/L, P < 0.001). On multivariate analysis, age > 8 years, elevated serum IgE (> 300 kIU/L), poor asthma control, and reduced FEV1/FVC ratio were independently associated with blood eosinophilia.
CONCLUSION
Childhood asthma with blood eosinophilia (an AEC of ≥ 400 cells/mm3) is associated with poor control, greater disease severity, and increased airflow limitation. Peripheral eosinophil count may serve as an important biomarker for risk stratification and personalized asthma management in a LMIC setting.
Core Tip: Asthma with blood eosinophilia (driven by type 2 inflammation) is associated with increased asthma severity and poor asthma control. In this retrospective cohort study, we included 176 children with asthma, of which 84 had eosinophilic asthma. Asthma with blood eosinophilia (asthma with an absolute eosinophil count of ≥ 400 cells/mm3) was associated with poor asthma control, greater disease severity, and increased airflow limitation. Peripheral eosinophil count may serve as a practical biomarker for risk stratification and personalized asthma management in a low-and-middle-income country setting.
