Chronic eosinophilic pneumonia progressing to lung fibrosis

Yoshida, Kazuhito; Shijubo, Noriharu; Koba, Hayato; Mori, Yuta; Satoh, Masashi; Morikawa, Taiyo; S, Abe

doi:10.1183/09031936.94.07081541

Cited by 43 publications

(25 citation statements)

References 10 publications

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“…However, there have been reports of cases in which patients developed significant fibrosis, with honeycombing and digital clubbing. (25) The diagnosis is made based on clinical criteria, a suggestive radiological profile and the presence of peripheral eosinophilia or eosinophilia in the BALF. A rapid response to corticosteroids facilitates confirmation of the diagnosis.…”

Section: Forms Of Pulmonary Eosinophilia Simple Pulmonary Eosinophiliamentioning

confidence: 99%

Eosinofilia pulmonar

Campos

Pereira

2009

J. bras. pneumol.

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Pulmonary eosinophilia comprises a heterogeneous group of diseases defined by eosinophilia in pulmonary infiltrates (bronchoalveolar lavage fluid) or in tissue (lung biopsy specimens). Although the inflammatory infiltrate is composed of macrophages, lymphocytes, neutrophils and eosinophils, eosinophilia is an important marker for the diagnosis and treatment. Clinical and radiological presentations can include simple pulmonary eosinophilia, chronic eosinophilic pneumonia, acute eosinophilic pneumonia, allergic bronchopulmonary aspergillosis and pulmonary eosinophilia associated with a systemic disease, such as in Churg-Strauss syndrome and hypereosinophilic syndrome. Asthma is frequently concomitant and can be a prerequisite, as in allergic bronchopulmonary aspergillosis and Churg-Strauss syndrome. In diseases with systemic involvement, the skin, the heart and the nervous system are the most affected organs. The radiological presentation can be typical, or at least suggestive, of one of three types of pulmonary eosinophilia: chronic eosinophilic pneumonia, acute eosinophilic pneumonia and allergic bronchopulmonary aspergillosis. The etiology of pulmonary eosinophilia can be either primary (idiopathic) or secondary, due to known causes, such as drugs, parasites, fungal infection, mycobacterial infection, irradiation and toxins. Pulmonary eosinophilia can be also associated with diffuse lung diseases, connective tissue diseases and neoplasia.Keywords: Pulmonary eosinophilia; Hypereosinophilic syndrome; Aspergillosis, allergic bronchopulmonary; Churg-Strauss syndrome. ResumoAs formas de eosinofilia pulmonar constituem um grupo heterogêneo definido pela presença de um ou dois critérios: infiltrado pulmonar com eosinofilia sanguínea e/ou eosinofilia tissular caracterizada por eosinófilos demonstrados na biópsia pulmonar ou no lavado broncoalveolar. Embora o infiltrado inflamatório seja composto de macrófagos, linfócitos, neutrófilos e eosinófilos, a presença de eosinofilia é um marcador importante para o diagnóstico e tratamento. A apresentação clínica e radiológica pode revelar eosinofilia pulmonar simples, pneumonia eosinofílica crônica, pneumonia eosinofílica aguda, aspergilose broncopulmonar alérgica e eosinofilia pulmonar associada à doença sistêmica, como na síndrome de Churg-Strauss e na síndrome hipereosinofílica. A asma está frequentemente associada, podendo ser um pré-requisito, como na aspergilose broncopulmonar alérgica e na síndrome de Churg-Strauss. Nas doenças com acometimento sistêmico, a pele, o coração e o sistema nervoso são os órgãos mais comprometidos. A apresentação radiológica pode ser considerada como típica, ou pelo menos sugestiva, para três formas de eosinofilia pulmonar: pneumonia eosinofílica crônica, aspergilose broncopulmonar alérgica e pneumonia eosinofílica aguda. A etiologia da eosinofilia pulmonar pode ser de causa primária (idiopática) ou secundária, compreendendo causas conhecidas, como drogas, parasitas, infecções por fungos e micobactérias, irradiação e toxinas. A eosinof...

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Section: Forms Of Pulmonary Eosinophilia Simple Pulmonary Eosinophiliamentioning

confidence: 99%

Eosinofilia pulmonar

Campos

Pereira

2009

J. bras. pneumol.

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“…The development of asthma following treatment may also occur [3,5,11]. Few case reports suggest unrecognized and repeated flares of ICEP may lead to progression to pulmonary fibrosis over a course of years [7]. To our knowledge, there have been no mortalities directly associated with ICEP.…”

Section: Discussionmentioning

confidence: 88%

“…Exclusion of parasitic or drug exposures as well as systemic and infectious etiologies, such as eosinophilic granulomatosis with polyangiitis or allergic bronchopulmonary aspergillosis, is key to making the diagnosis [1e4]. Due to the dramatic resolution in symptoms, oral corticosteroids are the mainstay of treatment [1e4, 6,7]. However, relapse is frequently seen following cessation, with reports varying from 37 to 58% risk of relapse within one year [2,5,8,9].…”

Section: Introductionmentioning

confidence: 99%

Chronic Eosinophilic Pneumonia: Adjunctive Therapy With Inhaled Steroids

Chan

DeLapp

Nystrom

2016

Chest

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a b s t r a c tIdiopathic chronic eosinophilic pneumonia (ICEP) is a rare form of diffuse parenchymal lung disease first identified by Carrington et al. in 1969. It is characterized by the presence of constitutional and respiratory symptoms with associated peripheral opacities on imaging and elevated serum and/or bronchoalveolar eosinophilia. Although data is limited regarding etiology or prevalence, it is known that ICEP has a 2:1 female: male predominance and typically affects non-smokers. Diagnosis rests on the clinical constellation of respiratory symptoms of at least 2e4 weeks duration, the presence of diffuse pulmonary alveolar consolidation, classically described as the "photographic negative of pulmonary edema", the presence of eosinophils !40% on bronchoalveolar lavage or !1000/mm 3 eosinophils on peripheral blood and the exclusion of other known causes of eosinophilic lung diseases such as drugs, toxins, fungi, parasites, and collagen-vascular disorders. A dramatic response is achieved with systemic corticosteroids, which is typically dosed over 6 months to 1 year. Despite this response, approximately 30e50% of patients will relapse upon cessation of steroids or during the taper. Although these patients respond well to another trial of steroids, the side effects of long term steroids are well known, including osteoporosis, diabetes, hypertension and cataracts. Inhaled corticosteroids as monotherapy has been trialed in the past without success. However, we report a case of a patient who underwent treatment with systemic corticosteroids followed by inhaled steroids who has remained in remission for 2 years.

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“…Cigarette smoking has been associated with increased BALF eosinophils in the setting of UIP, but masses of air space eosinophils are not seen in smokers' bronchiolitis. Chronic eosinophilic pneumonia, if untreated, can lead to irreversible pulmonary fibrosis (43,46). These patients tend to have a history of asthma and peripheral blood eosinophilia and evanescent episodes of a febrile debilitating illness and would not have the progressive downhill clinical course and unique pattern of subpleural, temporally heterogenous scarring of UIP.…”

Section: Discussionmentioning

confidence: 99%

Eosinophilic Pneumonia-like Areas in Idiopathic Usual Interstitial Pneumonia

Yousem

2000

Modern Pathology

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Usual interstitial pneumonia is the most common idiopathic chronic interstitial pneumonia, characterized by a temporally heterogenous pattern of interstitial injury with interstitial mononuclear infiltrates, septal fibromyxoid nodules, and parenchymal scarring. This report details the presence of focal eosinophilic pneumonia in six cases of usual interstitial pneumonia in the absence of known causes of this reaction. The relationship of eosinophilic infiltrates in usual interstitial pneumonia with regard to pathogenesis, differential diagnosis, and prognosis is discussed.

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Chronic eosinophilic pneumonia progressing to lung fibrosis

Cited by 43 publications

References 10 publications

Eosinofilia pulmonar

Eosinofilia pulmonar

Chronic Eosinophilic Pneumonia: Adjunctive Therapy With Inhaled Steroids

Eosinophilic Pneumonia-like Areas in Idiopathic Usual Interstitial Pneumonia

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