Acute and Chronic Eosinophilic Pneumonia: Clinical Evaluation and the Criteria.

Abstract

The clinical courses of ll cases of eosinophilic pneumonia which were clinico-pathohisto logically diagnosed and found to be unassociated with organic disorders producing peripheral blood eosinophilia were extensively investigated and compared with various types of eosinophilic pneumonia previously reported. Five cases of acute eosinophilic pneumonia fulfilled the follow ing criteria: 1) less than a one-month history of symptoms prior to diagnosis, 2) a short clinical course and 3) no recurrence. Six cases of chronic eosinophilic pneumonia fulfilled the following criteria: 1) more than a two-month history of symptoms prior to diagnosis, 2) a prolonged clinical course and 3) recurrence. The results suggested that various types of previously reported eosinophilic pneumonia classified by sex, the presence or absence of peripheral blood eosino philia, the degree of clinical symptoms or peripheral blood eosinophilia, and the degree of abnormalities on chest X-ray films should be extensively reevaluated. (Internal Medicine 31: 847-856, 1992)

Chronic Eosinophilic Pneumonia in a Breast Cancer Patient Post-Radiation Therapy: A Case Report

“…5 CEP is a disease of both females and males, with a preponderance in females. [4][5][6][7] It is extremely rare in children and has a peak incidence in adults of 50 years of age. 4,5 A third to a half of affected patients have a history of asthma, and ϳ90% of the cases either are nonsmokers or have a remote history of smoking, thus signifying a possible protective role for smoking.…”

“…3 On review of systems, patients may present with asthenia, nocturnal sweats, fever, and weight loss, occurring over Ͼ 2 months. 5,6 Blood may reveal peripheral eosinophilia and elevated levels of IgE in 90% and 50% of the cases, respectively. 4 Erythrocyte sedimentation rate and C-reactive protein may also be elevated.…”

“…15 This dramatic response to steroids has raised the question of the use of steroids as a diagnostic challenge. 5,6 The treatment dose is 0.5-1 mg of prednisone/kg/d. 5 The use of inhaled corticosteroids alone in the management of CEP is not optimal; however, when combined with systemic steroids, inhaled corticosteroids may improve the ability to taper and decrease the duration of treatment.…”

“…16,19 At least 6 months of tapering the dose of steroids is recommended. 6 If a patient has a recurrence after the taper is over, treatment should be for up to 1 year before discontinuing steroids. 6 If severe, vincristine and hydroxyurea have been shown to improve prognosis.…”

“…6 If a patient has a recurrence after the taper is over, treatment should be for up to 1 year before discontinuing steroids. 6 If severe, vincristine and hydroxyurea have been shown to improve prognosis. Plasmapheresis has been used, but its benefit is unknown.…”