Churg-Strauss Syndrome Versus Chronic Eosinophilic Pneumonia on High-Resolution Computed Tomographic Findings

Furuiye, Masashi; Yoshimura, Nobuyuki; Kobayashi, Akiko; Tamaoka, Meiyo; Miyazaki, Yasunari; Ohtani, Yoshio; Miyake, Shuji; Inase, Naohiko; Yoshizawa, Yasuyuki

doi:10.1097/rct.0b013e3181ae2949

Cited by 27 publications

(13 citation statements)

References 15 publications

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“…HRCT abnormalities in CSS include centrilobular nodules, bronchial wall thickening and bronchiectasis [2,[23][24][25], with the individualisation of two distinct imaging patterns: an airway pattern (consisting of small centrilobular nodules and tree-in-bud pattern, bronchial dilation, bronchial wall thickening and mosaic perfusion), and an airspace pattern (ground-glass opacities, consolidation and poorly defined nodules) [24]. Anomalies in HOB were very similar to the airway HRCT pattern reported in CSS, which is associated with airflow obstruction [24].…”

Section: Discussionmentioning

confidence: 99%

Hypereosinophilic obliterative bronchiolitis: a distinct, unrecognised syndrome

et al. 2012

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Biopsy-proven cases of eosinophilic bronchiolitis have only been reported in isolation, and all come from Japan.We present six patients with hypereosinophilic obliterative bronchiolitis (HOB), defined by the following criteria: 1) blood eosinophil cell count .1 G?L -1 and/or bronchoalveolar lavage eosinophil count .25%; 2) persistent airflow obstruction despite high-dose inhaled bronchodilators and corticosteroids; and 3) eosinophilic bronchiolitis at lung biopsy (n51) and/or direct signs of bronchiolitis (centrilobular nodules and branching opacities) on computed tomography (n56). Chronic dyspnoea and cough which was often severe, without the characteristic features of asthma, were the main clinical manifestations. Atopy and asthma were present in the history of three and two patients, respectively. One patient met biological criteria of the lymphoid variant of idiopathic hypereosinophilic syndrome. Mean blood eosinophil cell count was 2.7 G?L -1 and mean eosinophil differential percentage at bronchoalveolar lavage was 63%. Mean initial forced expiratory volume in 1 s/forced vital capacity ratio was 50%, normalising with oral corticosteroid therapy in all patients. HOB manifestations recurred when oral prednisone was decreased to 10-20 mg?day -1, but higher doses controlled the disease. HOB is a characteristic entity deserving to be individualised among the eosinophilic respiratory disorders. Thorough analysis is needed to determine whether unrecognised and/or smouldering HOB may further be a cause of irreversible airflow obstruction in chronic eosinophilic respiratory diseases.

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Section: Discussionmentioning

confidence: 99%

Hypereosinophilic obliterative bronchiolitis: a distinct, unrecognised syndrome

et al. 2012

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“…The original case series of CEP, along with a follow-up radiographic case series, described the chest X-rays of CEP patients as displaying peripheral opacities that are the "photographic negative" of pulmonary edema, which has endured as an identifying characteristic of the disease (19,121), though the lack of this pattern does not exclude CEP (68,105). CT imaging of the chest most often shows patchy airspace consolidations with a peripheral distribution, though patterns may vary (46,105,112,115). A representative chest X-ray and CT scan image from a patient with CEP are displayed in Fig.…”

Section: T Cells Also Have a Likely Role In Cep With Increases In mentioning

confidence: 99%

Eosinophilic Pneumonias

2012

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SUMMARY This review starts with discussions of several infectious causes of eosinophilic pneumonia, which are almost exclusively parasitic in nature. Pulmonary infections due specifically to Ascaris , hookworms, Strongyloides , Paragonimus , filariasis, and Toxocara are considered in detail. The discussion then moves to noninfectious causes of eosinophilic pulmonary infiltration, including allergic sensitization to Aspergillus , acute and chronic eosinophilic pneumonias, Churg-Strauss syndrome, hypereosinophilic syndromes, and pulmonary eosinophilia due to exposure to specific medications or toxins.

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“…CEP predominantly occurs in middle-aged women, and common symptoms include cough, fever, dyspnoea, fatigue and malaise [3,4]. In the peripheral lungs, the imaging features of CEP consist of multiple patchy infiltrations with ill-defined margins [5][6][7][8][9][10][11][12], and spontaneous migration of these infiltrates occurs in approximately 25% of patients [13]. Diagnosis relies on clinical signs, typical imaging findings and blood and/or alveolar eosinophilia once other aetiological diagnoses have been excluded.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of short-term prednisolone treatment in patients with chronic eosinophilic pneumonia

et al. 2015

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In patients with chronic eosinophilic pneumonia (CEP), dramatic improvements are seen in response to corticosteroid therapy; however, relapse is common after treatment has ceased. The optimal duration of corticosteroid therapy remains unclear.In a randomised, open-label, parallel group study, eligible patients with CEP received oral prednisolone for either 3 months (3-month group) or 6 months (6-month group), followed by 2 years observation. All patients were treated with an initial dose of prednisolone of 0.5 mg·kg −1 ·day −1, which was then tapered and discontinued at either 3 or 6 months. The primary end-point was relapse during the follow-up period.In the final analysis, there were 23 patients in the 3-month group and 21 patients in the 6-month group. All patients showed a good response to prednisolone treatment. There were 12 (52.1%) relapses in the 3-month group and 13 (61.9%) relapses in the 6-month group. No significant difference was found in the cumulative rate of relapse ( p=0.56). All relapse cases showed improvement upon resumption of prednisolone treatment.No difference was observed in the rate of relapse between the 3-and 6-month prednisolone treatment groups for patients with CEP. @ERSpublications Short-term, 3 month, prednisolone treatment is a therapeutic option for chronic eosinophilic pneumonia

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Churg-Strauss Syndrome Versus Chronic Eosinophilic Pneumonia on High-Resolution Computed Tomographic Findings

Abstract: On high-resolution computed tomography, the presence of the midzone distribution and nodules within GGOs without traction bronchiectasis suggests CSS rather than CEP.

Cited by 27 publications

References 15 publications

Hypereosinophilic obliterative bronchiolitis: a distinct, unrecognised syndrome

Hypereosinophilic obliterative bronchiolitis: a distinct, unrecognised syndrome

Eosinophilic Pneumonias

Efficacy of short-term prednisolone treatment in patients with chronic eosinophilic pneumonia

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