A Case of Cigarette Smoking-Induced Acute Eosinophilic Pneumonia Showing Tolerance

Shintani, Hiromoto; Fujimura, Masaki; Ishiura, Yoshihisa; Noto, Minoru

doi:10.1378/chest.117.1.277

Cited by 62 publications

(47 citation statements)

References 3 publications

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“…Another possibility is that irritation by the causative agent(s) was weak. This conclusion maybe supported by the cases reported by Shintani et al (13), Itoh et al (16) and Kawamotoet al (19) which showed mild ground-glass shadows after challenge test or natural history. In our case, BAL fluid from the right Ss showed high percentages of eosinophils and lymphocytes and the findings of transbronchial biopsy showed that the pathological reaction had already been established.…”

Section: Discussionsupporting

confidence: 74%

“…Further evidence for the role of smoking in AEPwas provided by Shintani et al (13) and Nakajima et al (14) who showed a positive reaction to cigarette smoking-challenge test. In this regard, Badesch et al (2) and Imokawa et al (20) suggested that AEPwas a variation of a pulmonary hypersensitivity reaction like hypersensitivity pneumonia.…”

Section: Discussionmentioning

confidence: 94%

“…In this context, Harita and Osada (18) reported that chest roentgenogram and CT showed diffuse fine nodular shadows bilaterally in a patient with AEP. Two other reports also described cases of AEPassociated with cigarette smoking which showed bilateral diffuse pulmonary infiltrates initially on the chest radiograph and mild reticulonodular shadows after smoking challenge tests (13,16). Thus, in AEP, localized fine nodular shadows on the chest radiograph are very rare.…”

Section: Discussionmentioning

confidence: 96%

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Acute Eosinophilic Pneumonia with Fine Nodular Shadows.

et al. 2003

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A 19-year-old womanpresented with acute onset of cough and dyspnea. She started smoking two weeks before the appearance of symptoms.On admission, arterial blood gas analysis on room air breathing revealed PaO2 55 Torr. Chest roentgenogram and high resolution computed tomogramsshowedlocalized fine nodular shadows at the right lower lung field. Bronchoalveolar lavage fluid revealed a high eosinophil count. Eosinophil infiltration was also observed in transbronchial lung biopsy specimens. The final diagnosis was acute eosinophilic pneumonia (AEP). Although few reports have demonstrated diffuse fine nodular shadows in AEP, localized fine nodular shadows on chest roentgenogram and CT may sometimes be the sign of AEP especially in the early phase of the clinical course. (Internal Medicine 42: 88-91, 2003)

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 96%

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Acute Eosinophilic Pneumonia with Fine Nodular Shadows.

et al. 2003

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“…It has been proposed that AEPis associated with cigarette smoke (2,3). However, there has been no histological evidence after a cigarette-smoking challenge test to support that cigarette smoke causes AEP(CS-AEP).…”

Section: Introductionmentioning

confidence: 99%

“…However, there has been no histological evidence after a cigarette-smoking challenge test to support that cigarette smoke causes AEP(CS-AEP). Shintani et al reported that tolerance develops to repeated resumption of smoking cigarettes in CS-AEP cases (3). But it is unclear whether eosinophils are attributed to the mechanismof tolerance.…”

Section: Introductionmentioning

confidence: 99%

Acute Eosinophilic Pneumonia Following Cigarette Smoking: A Case Report Including Cigarette-Smoking Challenge Test.

Watanabe¹,

Fujimura

Kondo

et al. 2002

Intern. Med.

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A 21-year-old womanpresented with acute progressive dyspnea. Chest computed tomography (CT) revealed diffuse bilateral infiltrates.Based on the results of transbronchial lung biopsy (TBLB) and bronchoalveolar lavage fluid (BALF) and her clinical course, she was diagnosed as having acute eosinophilic pneumonia. Wesuspected that the disease was related to smoking because she had started smoking ten days before the onset of symptoms. Therefore, a cigarette-smoking challenge test was done with the patient's informed consent. After the challenge, eosinophilic pneumonia was documented by BALF and TBLB findings, which were similar to those detected on admission, without significant radiographic findings.

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Acute Eosinophilic Pneumonia Among US Military Personnel Deployed in or Near Iraq

Shorr¹

2004

JAMA

226

180

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OSINOPHILIC LUNG DISEASES comprise a variety of processes ranging from Churg-Strauss syndrome to drug reactions. 1 Acute eosinophilic pneumonia (AEP) is a recently described syndrome characterized by a febrile illness, diffuse infiltrates on chest radiograph, and pulmonary eosinophilia. 2 Generally, patients with AEP present with respiratory failure requiring mechanical ventilation. 3,4 Clinicians may initially confuse AEP with severe communityacquired pneumonia, acute respiratory distress syndrome (ARDS), or both. It is unclear if less-severe forms of AEP exist. Histopathologically, lung biopsies in patients with AEP reveal both acute and organizing diffuse alveolar damage with eosinophils filling both the alveolar and interstitial spaces. 5 Peripheral eosinophilia may be noted in AEP; however, it is often absent at the time of presentation, which complicates efforts at diagnosis and case identification and suggests that the initial insult in this disease occurs in the lungs. Although a num

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A Case of Cigarette Smoking-Induced Acute Eosinophilic Pneumonia Showing Tolerance

Cited by 62 publications

References 3 publications

Acute Eosinophilic Pneumonia with Fine Nodular Shadows.

Acute Eosinophilic Pneumonia with Fine Nodular Shadows.

Acute Eosinophilic Pneumonia Following Cigarette Smoking: A Case Report Including Cigarette-Smoking Challenge Test.

Acute Eosinophilic Pneumonia Among US Military Personnel Deployed in or Near Iraq

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