Clinical Characteristics of 20 Patients with Chronic Eosinophilic Pneumonia: A 6-year Retrospective Study

Abstract

<jats:title>Abstract</jats:title> <jats:p><jats:bold>Background: </jats:bold>Chronic eosinophilic pneumonia (CEP) is a rare disease and there are few systematic studies on the disease. We summarized the clinical and pathological data of CEP to improve the understanding of the disease, as well as to reduce misdiagnosis and mistreatment.<jats:bold> </jats:bold><jats:bold>Methods: </jats:bold>The data of patients pathologically diagnosed as CEP in PLA General Hospital between May 2013 and May 2019 were collected, and the clinical manifestations, imaging characteristics, pathological features, treatment and prognosis were retrospectively analyzed.<jats:bold> </jats:bold><jats:bold>Results: </jats:bold>There were 20 patients with CEP, including 6 males and 14 females. The average age at the time of diagnosis was 47.0 ± 10.2 (22-83) years, and the average course of disease was 15.5 ±11.5 (2-72) months. The main clinical manifestations were cough, dyspnea, expectoration, and shortness of breath, and often accompanied by fever, weight loss, and asthenia. 19 patients had elevated peripheral blood eosinophils, with the proportion of eosinophils ranging from 5.3-64.7%, and the absolute value of eosinophils ranging from 0.72-14.43×10<jats:sup>9</jats:sup>/L. 18 patients had increased proportion of eosinophils in bronchoalveolar lavage fluid (BALF), ranging from 12-67%, with an average of 46%. The main imaging features were patchy shadows, consolidated shadows, and ground glass shadows. The histological examination of bronchial mucosal biopsy indicated eosinophilic infiltration in submucosal tissues and the pulmonary biopsy indicated a large number of eosinophils infiltration in alveolar cavity and septum as the main pathological changes of CEP. All of 20 patients were treated with glucocorticoid, and one of them relapsed during follow-up. <jats:bold>Conclusions:</jats:bold> The onset of CEP is insidious and the clinical manifestations are lack of specificity. Eosinophils increase in peripheral blood and BALF in most of CEP patients. The typical image is peripheral and subpleural distribution of lung infiltrates. The diagnosis of CEP depends on pathology, and glucocorticoid therapy is effective.</jats:p>