Charcot–Leyden Crystals in Rapidly Progressing Plastic Bronchitis

Eosinophilic plastic bronchitis: Case series and review of the literature

“…9 At the time of presentation to a hospital for evaluation, imaging often shows complete collapse of an entire lung or lobe. 2,9,10,18,25 This was the case in several of our patients.…”

“…7 In addition to being present in the sputum of those with asthma, Charcot−Leyden crystals are reportedly present in the casts found in eosinophilic plastic bronchitis in the majority of cases. 1,5,[8][9][10][11] Curschmann spirals, described by Heinrich Curschmann in 1882, are also seen in the sputum of patients with asthma and consist of white or yellow mucus threads bound by fibrils. 6 In our case series, demonstrated that many patients with single ventricle physiology who undergo palliation surgery develop lymphatic abnormalities that can be seen on MR lymphangiography and treated with percutaneous lymphatic interventional procedures.…”

“…21 In one case report of eosinophilic plastic bronchitis in the setting of acute influenza A infection, abundant EETs and eosinophilic granule proteins were found in histopathologic examination of a bronchial cast. 10 Authors hypothesized that that influenza infection triggered EETosis which led to the crystallization of galectin-10, formation of Charcot−Leyden crystals, and ultimately bronchial cast formation. While it is clear that in the majority of cases in which Charcot−Leyden crystals are formed (various allergic, oncologic, and infectious diseases), 7 no bronchial cast is found, it may be that eosinophilic plastic bronchitis occurs because of an accentuated EETosis that is triggered by an unknown mechanism.…”

Plastic bronchitis caused by Haemophilus influenzae

“…This viscous DNA has been reported to contribute to the formation of mucous plugs in plastic bronchitis 3 . Plastic bronchitis has also been reported in patients with bronchial asthma, 4 and the aetiology of plastic bronchitis in our patient may be attributed to a combination of bronchial eosinophil activation induced by uncontrolled bronchial asthma and increased bronchial secretions due to H. influenzae infection.…”

Aggregated eosinophils characterize airway mucus properties

“…For instance, eosinophilic chronic rhinosinusitis (ECRS) is resistant to conservative treatments using antimicrobial therapies or nebulizers, and frequently requires surgical intervention for mucus removal, which is in contrast to infectious rhinosinusitis (6,7). Luminal impaction due to viscous mucus is also observed in other eosinophilic upper and lower airway diseases such as eosinophilic otitis media (5), allergic fungal sinusitis (8), allergic bronchopulmonary aspergillosis (9)(10)(11), plastic bronchitis (12,13), and eosinophilic asthma (14)(15)(16). Eosinophilic airway mucus has been clinically recognized as allergic mucin, eosinophilic mucin, and mucus plug, and its consistency has been described as being like chewing gum, cottage cheese, axle grease, and peanut butter, which can be a clue to the diagnosis (17)(18)(19).…”