Acute Eosinophilic Pneumonia Caused by Cigarette Smoking.

Abstract

It has been suggested that acute eosinophilic pneumonia (AEP) is associated with cigarette smoking because in Japan, the patients with AEPare young and have a high incidence of short-term smoking history. However, there has been no direct evidence to support that cigarette smoke causes AEP. Herein is reported the first case showing the direct evidence and a long-term clinical course of cigarette smoking-induced AEP, in which tolerance to repeated resumption of smokingcigarettes might have occurred. We should pay attention to the history of cigarette smoking in seeing patients with AEP, especially in young patients.

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

“…This patient also showed the tolerance to repeated resumption of smoking cigarettes. The mechanismof tolerance remains unknown.Shintani et al speculated some possible mechanisms; desensitization to repeated resumption of smoking cigarettes, and the interaction of virus infection and/or given drugs with cigarette smoke (4). In this case the CD4/CD8 ratio of lymphocytes and the percentage of neutrophils in BALFafter challenge was decreased compared with those at the onset, while the percentage of eosinophils in BALFafter challenge was muchthe sameas that at the onset.…”

Pulmonary Manifestations of Acute Lung Injury: More Than Just Diffuse Alveolar Damage

“…28,30,31 AEP has also been reported as a consequence of recent initiation of cigarette smoking. 32,33 AEP is generally characterized by varying degrees of intraalveolar fibrin, macrophages, and eosinophils. Hyaline membranes similar to those seen in the acute phase of DAD may also be seen (Figures 4 and 5).…”

Cigarette Smoking-induced Acute Eosinophilic Pneumonia Showing Tolerance in Broncho-alveolar Lavage Findings

“…Many acute eosinophilic pneumonia (AEP) cases associated with cigarette smoking (CS) in young people have been reported, mainly in Japan (1)(2)(3)(4)(5)(6)(7)(8)(9)(10). Although many kinds of positive findings on the smokingchallenge test have been reported (3,4,(6)(7)(8)(9)(10), including recurrence of symptoms, hypoxemia, worsening of lung function, and an increase of eosinophils in broncho-alveolar lavage (BAL) fluid, it is thought that patients will not experience severe acute respiratory failure again even if they resume CS because a tolerance gradually develops through repeated CS (3, 4, 9-ll).…”