ABSTRACT
The terms 'eosinophilic pneumonia' and 'eosinophilic lung disease' loosely describe a heterogeneous group of pulmonary diseases of varying aetiologies and severity. The diseases are characterised by infiltration of lung parenchyma by eosinophils; peripheral eosinophilia is not required for diagnosis. In this article; major clinical entities are appraised with respect to clinical; pathological and radiological features. Diseases without pulmonary infiltration or radiographic abnormalities; such as allergic asthma; are not included in this review
Subject(s)
Lung Diseases , Pulmonary Eosinophilia , Pulmonary Eosinophilia/etiology , ReviewABSTRACT
Los síndromes de infiltrados pulmonares con eosinofilia (síndromes PIE) constituyen un grupo heterogéneo de desórdenes poco frecuentes, de diferente etiopatogenia y presentación clínica variable. Estos cuadros tienen en común la presencia de infiltrados pulmonares y eosinofilia periférica, en el lavado broncoalveolar y en el intersticio pulmonar; aunque además pueden existir síntomas sistémicos. Actualmente se recomienda clasificar a los síndromes PIE según la etiología en idiopáticos y secundarios. Dentro de los primeros se encuentran la eosinofilia pulmonar simple (síndrome de Loeffler), neumonía eosinofílica aguda, neumonía eosinofílica crónica, síndrome hipereosinofílico idiopático, granulomatosis alérgica o síndrome de Churg- Strauss y granulomatosis broncocéntrica. Los secundarios incluyen la aspergilosis broncopulmonar alérgica, eosinofilia inducida por parásitos (forma más frecuente en pediatría) y por drogas. Los corticoides constituyen el tratamiento de elección, en cambio cuando la etiología son parásitos la terapia debe ser hecha con fármacos antiparasitarios. Se debe tener un alto índice de sospecha en el diagnóstico, debido a la escasa frecuencia que presentan estos síndromes y a la significativa morbilidad y en ocasiones mortalidad, especialmente la neumonía eosinofílica aguda, que se manifiesta frecuentemente con insuficiencia respiratoria severa de etiología desconocida.
Subject(s)
Humans , Child , Pulmonary Eosinophilia/diagnosis , Pulmonary Eosinophilia/therapy , Acute Disease , Algorithms , Bronchoalveolar Lavage , Chronic Disease , Adrenal Cortex Hormones/therapeutic use , Pulmonary Eosinophilia/classification , Pulmonary Eosinophilia/etiology , Parasites/pathogenicity , Pharmaceutical Preparations/adverse effects , SyndromeABSTRACT
The mechanism and cause of acute eosinophilic pneumonia are largely unknown. Many factors including the smoking of cigarettes have been suggested, but none have been proven to directly cause acute eosinophilic pneumonia. The authors report a case of acute eosinophilic pneumonia in a young Asian male who recently started smoking. The diagnosis was made based on his clinical course and results of chest radiography, lung spirometry, bronchoalveolar lavage, and transbronchial lung biopsies. After administration of methylprednisolone, his clinical course rapidly improved. A provocation test was designed to establish a connection between cigarette smoking and the development of acute eosinophilic pneumonia. After the provocation test, the patient showed identical symptoms, increase in sputum eosinophils, and worsening of pulmonary function. The results of the provocation test suggest that smoking may directly cause acute eosinophilic pneumonia, and support previous reports of cigarette smoking-induced acute eosinophilic pneumonia.
Subject(s)
Adolescent , Humans , Male , Acute Disease , Bronchial Provocation Tests , Pulmonary Eosinophilia/etiology , Smoking/adverse effectsABSTRACT
In 1932, Loffler described a syndrome of self-limiting, transient pulmonary infiltrates associated with peripheral blood eosinophilia and mild pulmonary symptoms. A number of conditions are related to pulmonary eosinophilia or pulmonary infiltration with eosinophilia. Especially, parasitic infestations are often related to pulmonary eosinophilia, but only two cases associated with Clonorchis sinensis have been anecdotally reported in English literature. Here we report a case of migrating pulmonary eosniophilic infiltrations associated with Clonorchis sinensis that was successfully treated with praziquantel. Clonorchiasis should be considered in patients with marked eosinophilia and pulmonary infiltrations.
Subject(s)
Animals , Humans , Male , Middle Aged , Biopsy , Clonorchiasis/complications , Clonorchis sinensis/isolation & purification , Pulmonary Eosinophilia/etiology , SyndromeABSTRACT
Drugs are well known causes of eosinophilic lung disease. In many patients, drug-induced eosinophilic lung disease presents with transient eosinophilic infiltrates that disappear after discontinuation of the drug. Some patients, however, experience a fulminant, acute eosinophilia-like disease. Recently, we experienced a case of amitriptyline-associated acute eosinophilic pneumonia with respiratory failure in a diabetic hemodialysis patient. Eight days after treatment with amitriptyline, sudden fever, chill, dry cough and dyspnea developed. Subsequently, multiple patch consolidations appeared on the chest radiographs. Bronchoalveolar lavage (BAL), established a diagnosis of acute eosinophilic pneumonia. After immediate discontinuation of amitriptyline, a rapid clinical and radiological improvement was observed. The present case indicates that the possibility of acute eosinophilic pneumonia should be fully considered in dialysis patients developing unexplained respiratory symptoms while on amitriptyline therapy.
Subject(s)
Adult , Female , Humans , Acute Disease , Amitriptyline/adverse effects , Antidepressive Agents, Tricyclic/adverse effects , Pulmonary Eosinophilia/etiology , Renal DialysisABSTRACT
Infection with Wuchereria bancrofti, Brugia malayi, or B. timori not only affects the structure and function of lymphatic vessels but is also associated with extralymphatic pathology and disease. Because it is now possible to detect living adult worms by ultrasonography, much emphasis is placed on lymphatic pathology. However, the finding of renal damage in asymptomatic microfilaremic carriers has led to increased recognition of the importance of extralymphatic clinical manifestation in bancroftian filariasis. The authors present a number of clinical syndromes that may be manifestations of extralymphatic filarial disease and discuss possible mechanisms that cause these conditions. The main purpose of this paper is to raise the awareness of students and physicians of the prevalence and the importance of extralymphatic disease in bancroftian filariasis so that it is diagnosed and treated properly and also to alert for the need of additional research in this area.
Subject(s)
Humans , Arthritis/etiology , Exanthema/etiology , Filariasis/complications , Granuloma/etiology , Kidney Diseases/etiology , Pulmonary Eosinophilia/etiology , Splenomegaly/etiologyABSTRACT
La Enfermedad Pulmonar Eosinófila es producida por diferentes patologías, en las cuales hay un aumento de los eosinófilos tisulares y circulantes. Los mecanismos patogénicos, en la mayoría de las causas están pobremente aclarados. Entre los desórdenes que pueden desencadenarla se encuentran hipersensibilidad a drogas; secundaria a enfermedad parasitaria; micosis; vasculitis y otras enfermedades infecciosas como la tuberculosis. También puede acompañar a neoplasias como carcinoma broncogénico y enfermedad de Hodgkin. Se presenta el caso de un paciente de sexo masculino, de 45 años de edad con SIDA y Tuberculosis Pulmonar, que durante el tratamiento desarrolla eosinofilia periférica e infiltrados fugases (periféricos y bilaterales) en la radiografía de tórax. Se concluye que los pacientes con Sida y Tuberculosis, tienen mayor proporción de reacciones adversas a drogas, y que la Tuberculosis puede desencadenar per se una Eosinofilia Pulmonar Simple o Idiopática.
Subject(s)
Humans , Male , Middle Aged , Pulmonary Eosinophilia/etiology , Pulmonary Eosinophilia/physiopathology , Acquired Immunodeficiency Syndrome/complications , Tuberculosis, Pulmonary/complications , Carcinoma, Bronchogenic/complications , Drug Hypersensitivity , Hodgkin Disease/complications , Mycoses , Rifampin/adverse effects , Sulfasalazine/adverse effectsABSTRACT
Presentamos el caso de una mujer de 38 años con asma, eosinofilia periférica, sinusitis y opacidades interticiales difusas, bilaterales y fugaces en la radiografía de tórax. El procedimiento diagnóstico fue biopsia pulmonar a cielo abierto donde se encontró una vasculitis eosinofilica características del Síndrome de Churg-Strauss. Comentamos los principales hallazgos clínicos, radiológicos e histopatológicos.
Subject(s)
Humans , Female , Adult , Churg-Strauss Syndrome/surgery , Churg-Strauss Syndrome/classification , Churg-Strauss Syndrome/complications , Churg-Strauss Syndrome/diagnosis , Churg-Strauss Syndrome/epidemiology , Churg-Strauss Syndrome/etiology , Churg-Strauss Syndrome/physiopathology , Churg-Strauss Syndrome/mortality , Churg-Strauss Syndrome/pathology , Churg-Strauss Syndrome/drug therapy , Churg-Strauss Syndrome , Churg-Strauss Syndrome/therapy , Pulmonary Eosinophilia/complications , Pulmonary Eosinophilia/diagnosis , Pulmonary Eosinophilia/drug therapy , Pulmonary Eosinophilia/epidemiology , Pulmonary Eosinophilia/etiology , Pulmonary Eosinophilia/physiopathology , Pulmonary Eosinophilia/surgery , Pulmonary Eosinophilia/therapyABSTRACT
A presente revisäo bibliográfica tem como objetivo alertar os profissionais da área de saúde para as hipereosinofilias transitórias e auto-resolutivas na regiäo do Grande Recife-Brasil, área endêmica de filariose bancroftiana. Os autores fazem consideraçSes gerais (aspectos imunológicos, etiológicos e patológicos) sobre a Síndrome de Loffler (SL), que é largamente distribuída nas áreas tropicais, sub-tropicais e em climas temperados. Ressaltam a importância es síndrome e a eosinofilia pulmonar tropical like (EPT-like), onde os agentes etiológicos seriam o áscaris, stroongyloides e, possívelmente, os Ancilostomídeos. Tanto a EPT como a EPT-like säo de longa duraçäo, podendo cursar em alguns pacientes con níveis de eosinófilos semelhantes a SL, porém, geralmente säo mais elevados. No tocante às diversas formas clínicas de filariose, os autores descartam: (a) relaçäo direta de hipereosinofilia com a presença do verme microfilária e/ou verme adulto, exceçäo de EPT e (b) a validade do teste de imunofluorescência indireta para o diagnóstico da filariose doença ou infecçäo, ainda largamente utilizada na nossa regiäo
Subject(s)
Humans , Male , Female , Filariasis , Pulmonary Eosinophilia/diagnosis , Pulmonary Eosinophilia/etiology , Pulmonary Eosinophilia/therapy , Enterobius , FilariasisSubject(s)
Pulmonary Eosinophilia/etiology , Alveolitis, Extrinsic Allergic/complications , Eosinophilia/complications , Granulomatosis with Polyangiitis/complications , Granulomatosis with Polyangiitis/diagnosis , Polyarteritis Nodosa/complications , Polyarteritis Nodosa/diagnosis , Pulmonary Eosinophilia/classification , Pulmonary Eosinophilia/diagnosis , Surveys and Questionnaires , Vasculitis/complicationsSubject(s)
Biopsy , Child , Child, Preschool , Diagnosis, Differential , Diagnostic Imaging , Female , Humans , Lung/pathology , Lung Diseases, Parasitic/diagnosis , Male , Pulmonary Eosinophilia/etiologyABSTRACT
Se presenta un caso de una paciente de 49 años de edad, sexo femenino, con diagnóstico de neumonía eosinifílica crónica asociada con asma. Se describen las características clínicas, radiológicas y de laboratorio. Presenta antecedentes familiares alérgicos, una historia aprevia de rinitis perenne y asma bronquial de larga evolución. El diagnóstico de este paciente se realizó teniendo en cuenta: 1) el cuadro clínico; 2) la hipereosinofilia periférica, y 3) el infiltrado pulmonar característico. Además se consideró la respuesta espectacular al tratamiento corticoideo, con desaparición de los síntomas clínicos y radiológicos con cinco días de tratamiento
Subject(s)
Middle Aged , Female , Humans , Asthma/complications , Eosinophilia/etiology , Pulmonary Eosinophilia/etiology , Adrenal Cortex Hormones/therapeutic use , Aspergillosis, Allergic Bronchopulmonary/diagnosis , Beclomethasone/therapeutic use , Chronic Disease , Diagnosis, Differential , Eosinophils/immunology , Eosinophils/metabolism , Eosinophilia/classification , Pulmonary Eosinophilia , Pulmonary Eosinophilia/drug therapy , Rhinitis, Allergic, Perennial/complications , Tuberculosis, Pulmonary/diagnosisABSTRACT
The case of a 20 years old female suffering from pulmonary eosinphilia with bronchial asthma who had been on various drug regimes for a long time, is described. She was given antimycotic drugs resulting in prompt relief
Subject(s)
Female , Pulmonary Eosinophilia/etiology , Hypersensitivity/complications , Aspergillus/pathogenicity , Social ClassABSTRACT
Se estudiaron los primeros 44 adultos que aparecieron en Fomento en el curso de una epidemia de Fascioliasis. Se comprobó la ingestión frecuente y reciente de berro en la población en el 88,6% de los pacientes. La fiebre no fue un signo característico observado, pero sí la eosinofilia. El 14% de los pacientes se diagnosticó por el hallazgo de huevos de Fasciola hepática en las heces y el 69% por serología