What Is Pulmonary Eosinophilia?

Pulmonary eosino-philia (PE), also known as eosinophilia, is a group of diseases that are characterized by increased eosinophils in the circulation or tissues. The clinical manifestations have varying degrees of Chest tightness, shortness of breath, fatigue, low fever, cough and wheezing. X-ray examination of the lungs has plaques, cloud-like scattered or migratory infiltrates; systemic symptoms vary, and the course of the disease varies greatly. It can be divided into 5 categories clinically: simple, chronic or persistent, asthmatic, tropical and pulmonary allergic vasculitis and granulomatous.

Pulmonary eosino-philia (PE), also known as eosinophilia, is a group of diseases that are characterized by increased eosinophils in the circulation or tissues. The clinical manifestations have varying degrees of Chest tightness, shortness of breath, fatigue, low fever, cough and wheezing. X-ray examination of the lungs has plaques, cloud-like scattered or migratory infiltrates; systemic symptoms vary, and the course of the disease varies greatly. It can be divided into 5 categories clinically: simple, chronic or persistent, asthmatic, tropical and pulmonary allergic vasculitis and granulomatous.

Chinese name

Pulmonary eosinophilia

English name

pulmonary eosinophilia

definition

Hypersensitivity diseases caused by various causes. Under the stimulation of protozoan infection, chemicals, drugs and other allergens, the lungs locally produce eosinophil chemokines, which mediate infiltration and activation of eosinophils, causing tissue damage and inflammatory response by releasing inflammatory mediators.

Applied discipline

Immunology (level 1 discipline), immunopathology, clinical immunity (level 2 discipline), hypersensitivity (level 3 discipline)

The above content was published by the National Science and Technology Terminology Examination Committee.

nickname

Eosinophilia

Visiting department

Respiratory Medicine

Common causes

Infection with parasites, drug reactions, allergic reactions, etc.

Common symptoms

Chest tightness, shortness of breath, fatigue, low fever, cough and wheezing, etc.

Causes of pulmonary eosinophilia

Simple pulmonary eosinophilia

Allergic reactions are often caused by parasites as antigens. In addition, it is a drug reaction such as PAS, aspirin, furantoin, barbiturates, thiouracil, penicillin, sulfonamides and the like. Inhalation of pollen and fungal spores can also cause it.

2. Persistent pulmonary eosinophilia

The etiology is similar to that of simple pulmonary eosinophilia. Parasites are mostly hookworms and roundworms. Furantoin is more common in drug allergies. Others include sporozoosis and brucellosis.

3. Asthmatic pulmonary eosinophilia

Can be caused by Aspergillus, worms, schistosomiasis, and filariasis. Can also be caused by pollen, organic dust, animal feathers, dander, drugs and other allergies.

4. Tropical eosinophilia

Weingarten and others were first discovered in India in 1943, and later found in Africa, Southeast Asia, and southern China. The occurrence of this disease is closely related to filariasis infection or allergies.

5. Pulmonary allergic vasculitis and granulomas

The etiology is unknown. It is believed that allergy to serum, drugs (sulfa, thiouracil, penicillin, hemolytic streptococcus, etc.) is related to the cause of type III allergies.

Clinical manifestations of pulmonary eosinophilia

Simple pulmonary eosinophilia

The clinical manifestations are mild. They are often found during X-ray examination, only a slight cough, a small amount of sticky sputum, fatigue, chest tightness, occasional fever, mostly low fever, like a cold.

2. Persistent pulmonary eosinophilia

It is more common among young and middle-aged people, and more women than men. Chronic onset, symptoms are more severe than simple pulmonary eosinophilia, fever, cough, asthma, fatigue, hemoptysis, hepatosplenomegaly, and pleural effusion. Often accompanied by changes in lung function, ventilatory and diffuse functions are impaired, accompanied by hypoxemia, and even respiratory failure can occur, physical examination can be heard and fine wet rales in the lungs.

3. Asthmatic pulmonary eosinophilia

Patients with this disease usually develop in adulthood and are more common in women. Cough, mucus, phlegm, fever, and general discomfort during an acute attack. The symptoms of shortness of breath after coughing up sputum can be relieved. Lung atelectasis can occur in the bronchioles with mucus plugs. Blocking the distal bronchus can cause secondary infection of the lungs, which can form bronchiectasis over time. The disease is prone to recurrence, the duration of the disease varies, and it often persists.

4. Tropical eosinophilia

Occurs in tropical and subtropical areas. Slow onset, often fever, fatigue, poor appetite, paroxysmal dry cough, etc., or a small amount of mucus and sputum, or blood in the sputum, wheezing and wet wheezing in the lungs, and swelling of the liver and lymph nodes Big. The course is long and can be delayed for months to years.

5. Pulmonary allergic vasculitis and granulomas

Clinically, fever, cough, hemoptysis, and wheezing are the main symptoms. In addition to lung lesions, the kidneys, skin, and nervous system are also affected, and corresponding symptoms and signs appear.

Pulmonary eosinophilia test

Blood test

The proportion of blood eosinophils increases, often exceeding 20%. Eosinophils increased significantly and the total number of white blood cells increased. Microfilariae can be found in the blood of people caused by filariasis infection.

2. Immunological examination

In some patients, serum lgE and lgG levels were elevated; the serum complement of the filariasis antigen was positive in patients with filariasis infection; in patients with aspergillus, aspergillus antigens were used as skin tests to show immediate and delayed biphasic positive reactions.

3. Sputum examination

There are a large number of eosinophils in the sputum. Aspergillus mycelia can be found in the sputum of some patients.

4. Fecal examination

Infections caused by intestinal parasites such as roundworms and hookworms can be found in parasite eggs.

5.X-ray inspection

Variable patchy, cloud-like, or nodular shadows can be seen in both lung fields. Some still show hilar lymphadenopathy and bronchiectasis.

Treatment of pulmonary eosinophilia

Corresponding treatment according to different causes. Those who have cough and expectorant can be given expectorants and cough suppressants. Co-infected patients are given effective antibiotics.