Eosinophilic Lung Diseases

Abstract

Eosinophilic lung disease broadly describes a diverse group of diffuse parenchymal lung diseases and airway disorders unified by the presence of marked pulmonary eosinophila and/or peripheral blood eosinophilia, and varying patterns of physiological, gas exchange, or radiographic abnormalities. Depending on the specific cause, other compartments of the lung including the blood vessels and/or pleura may also be affected. These disorders may be idiopathic and restricted to the lung or part of a systemic eosinophilic syndrome. Diagnosis remains challenging given the diverse clinicoradiologic patterns that may be seen, as well as the potential for overlapping clinical manifestations among the competing diagnostic considerations. Although corticosteroids represent first-line therapy in many of these disorders, important advances in the understanding of the eosinophil biology and specific disease pathogenesis, such as those with hypereosinophilic syndromes, have led to the development of novel targeted therapies. This clinical review focuses on the most current diagnostic and management strategies of the patient with eosinophilic lung disease. FIGURE 4. A, Hematoxylin and eosin (H&E) Â 20: allergic mucin filling a dilated bronchus. B, H&E Â 40: allergic mucin composed of necrotic eosinophils and other inflammatory cells within a background of mucin and proteinaceous exudates. C, H&E Â 40: Charcot-Leyden crystals (arrows) and other inflammatory cells within background of mucin and proteinaceous exudates. D, H&E Â 40: GMS special stain showing fungal hyphae in allergic mucin.

Case Report Muscle pain, fever, cough, and progressive dyspnea in a woman with eosinophilic pneumonia

“…The diagnosis of EP requires both typical radiological features and alveolar eosinophilia with or without peripheral eosinophilia. Increased eosinophil counts in the bronchoalveolar lavage fluid (BALF) confirm a diagnosis of EP (Fernández Pérez et al, 2011). However, in some difficult cases, such as our case, the alveolar eosinophils and peripheral eosinophils are found only in pulmonary infiltrates.…”

Primary Eosinophilic Lung Diseases and the Therapeutic Role of Corticosteroids: A Case Report and Literature Review

“…Underlying diseases known to cause eosinophilia should be ruled out such as infections, parasitic infestations, allergic diseases, drugs, lung diseases, connective tissue diseases, skin diseases and primary malignancies (Fernandez Perez and Frankel, 2013;Brito-Babapulle, 2003;Lim et al, 2014). It is also imperative to rule out myeloid malignancies by peripheral blood film analysis, vitamin B12 assay, FIP1L1 PDGFRa fusion gene analysis, bone marrow biopsy and cyogenetics.…”

Pulmonary eosinophilias, diagnosis and therapy approach

“…Прогноз благоприятен; как правило, не требуется назначения ГКС, поскольку происходит спонтанное разрешение инфильтратов в течение месяца [23].…”

“…В большинстве случаев причина остается неизвест ной, не связана с БА [23]. Известные причины вклю чают в себя лекарственные аллергические реакции (на сертралин, БЦЖ вакцину, миноциклин, йодконтраст ные вещества, инъекцию прогестерона и ингаляцию кокаина), гемотрансфузии, инвазию паразитов в лег кие, а также массивную ингаляцию заплесневелого се на.…”

“…ГКС на значают только на этапе мультиорганного пораже ния. При низкой эффективности ГКС к лечению до бавляют циклоспорин, интерферон α [23,33].…”