What Is Eosinophilic Pneumonia?

Eosinophilic pneumonia is a group of diseases with a known or unknown etiology, characterized by infiltration of eosinophils, and often accompanied by an increase in eosinophils in the surrounding blood.

Eosinophilic pneumonia

Basic overview of eosinophilic pneumonia

Sometimes called eosinophilic pulmonary infiltration (PIE) syndrome.

Etiology and pathogenesis of eosinophilic pneumonia

Causes include parasites (such as roundworms, toxocara and filariasis), drugs (such as penicillin, p-aminosalicylic acid, hydrazine, pyridazine, furantoin, chlorpromazine, sulfa preparations); chemical allergies (such as vapor forms) Inhaled nickel carbide); and fungi (such as Aspergillus fumigatus, which causes allergic bronchopulmonary aspergillosis, see below). Although allergic mechanisms are suspected, the cause of most eosinophils pneumonia is unknown. Eosinophilia suggests that Type I allergic reactions, and other characteristics of the syndrome (vasculitis, round cell infiltration) suggest that type III may also be type IV reactions.

Eosinophilic pneumonia (Table 76-3) is often associated with bronchial asthma. Eosinophilic pneumonia associated with asthma and unknown etiology can be divided into three categories: exogenous bronchial asthma with PIE syndrome, in fact, it often changes Allergic bronchopulmonary aspergillosis; endogenous bronchial asthma with PIE syndrome (chronic eosinophilic pneumonia), characteristic peripheral lung infiltrates on chest radiographs; and allergic granulomatosis (Churg-Strauss syndrome , A kind of nodular polyarthritis with pulmonary disease). Simple eosinophilic pneumonia (L & Ouml; ffler syndrome) may occasionally be complicated by asthma.

Eosinophilic pneumonia without asthma includes acute eosinophilic pneumonia, eosinophilic myalgia syndrome, and eosinophilic syndrome. Acute cellular pneumonia is a different disease of unknown cause and can cause acute Fever, severe hypoxemia, diffuse pulmonary infiltration and bronchoalveolar lavage fluid> 25% of eosinophils. Corticosteroid treatment can quickly and completely alleviate. Eosinophilic myalgia syndrome and consumption of large amounts of L-tryptophan as a food additive. Lung infiltration can be accompanied by myalgia, muscle weakness, rash and induration of soft tissue similar to scleroderma. The diagnostic criterion for eosinophilic syndrome is persistent eosinophilia (> 1500 / mm3) for more than 6 months, lack of other causes of eosinophilia, involving the heart, liver, spleen, central nervous system or lung, the heart is most commonly affected. Fever, weight loss and anemia are also common, often Arterial rather than venous thromboembolic disease can occur.

Characteristic changes include eosinophils, large monocytes filled with alveoli, infiltration of eosinophils, plasma cells, and large and small monocytes in the alveolar space. There may also be bronchial mucus packing and vascular infiltration.

Eosinophilic pneumonia symptoms and signs

Symptoms and signs can be mild or life-threatening. May be accompanied by low-grade fever, mild (if any) respiratory symptoms, and immediate recovery. Other types of PIE syndrome may have symptoms of fever and bronchial asthma, including cough, wheezing And dyspnea at rest. If left untreated, chronic eosinophilic pneumonia often progresses to life-threatening, similar to acute eosinophilic pneumonia. Eosinophils often increase significantly (20% to 40%, sometimes higher) X-rays of the chest show invasive lesions (walking infiltration) that appear and disappear quickly in different lung lobes.

Clinical diagnosis of eosinophilic pneumonia

Look for pathogenic worms based on the geographic area where the patient lives. Parasites and Aspergillus fumigatus can be found in sputum. Careful history of medication is needed. Differential diagnosis includes tuberculosis, sarcoidosis, Hodgkin's disease and other lymphoid tissue proliferative diseases, lung Acidic cell granuloma, desquamative interstitial pneumonia, and collagenous vascular disease. Allergic pneumonia and Wegener granulomatosis are often not accompanied by eosinophilia.

Eosinophilic pneumonia treatment

The disease can be self-limiting, benign, and does not require treatment. If the symptoms are severe, the use of corticosteroids often has excellent results; for patients with acute eosinophilic pneumonia and idiopathic chronic eosinophilic pneumonia, the treatment can save lives. When bronchial asthma occurs, the usual treatment method is adopted. If there is a worm infection, an insect repellent should be used.