Chronic Eosinophilic Pneumonia

Abstract

An association betwen migratory pulmonary infiltrates and peripheral eosinophilia has been known for at least 40 years. Diagnostic challenges still exist in the classifications within this syndrome. We describe a 33-year-old female without asthma but with definite ‘atopy’ who had a 4-year history of recurring pulmonary lesions. These were sometimes segmental, at other times dense and peripheral, and once there was lobar atelectasis due to mucoid impaction. Diagnosis by lung biopsy revealed eosinophilic pneumonia with bronchiolitis obliterans as a prominent feature. Steroid treatment resulted in prompt improvement; during a 5-year follow-up the infiltrates have not recurred but there has been persistent mild obstruction.

Thrombocytosis in Chronic Eosinophilic Pneumonia

“…6 The presently advocated policy is to perform lung biopsy only in the atypical case where some uncertainty exists despite thorough clinical evaluation. 4 ' 7,8 Thrombocytopenia, for instance, may be a clue to a hematologic malignancy presenting with pulmonary eosinophilia, as was recently seen in our institution. 9 Likewise, thrombocytosis is associated 1 with conditions that may present with pulmonary eosinophilia such as lymphomas, carcinomas, collagen diseases, tuberculosis and sarcoidosis.…”

Idiopathic Chronic Eosinophilic Pneumonia

“…When multiple chest radiographs are performed before a diagnosis is made, the migratory character of the infiltrates is often evidenced. 2,3,7,20 Pleural effusions are uncommon, even when searched for on computed tomography. 3 Computed tomography may show discrete ground-glass opacities that are not discernible on radiography.…”

Chronic eosinophilic pneumonia complicating long-standing rheumatoid arthritis

“…None of their patients had rheumatoid arthritis and arthritis has not been noted in subsequent reports (Morrissey et al, 1975). Moreover rheumatoid arthritis is not a recognized cause of pulmonary eosinophilia (Crofton et al, 1952).…”