Differential diagnosis of pulmonary eosinophilia

Piggott, Laura M.; Gill, Cara M.; Kent, Brian D.

doi:10.1183/2312508x.10029420

Cited by 5 publications

(5 citation statements)

References 127 publications

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“…Around the same time, Crofton and co-workers classified PIE into five sub-groups: simple pulmonary eosinophilia; prolonged pulmonary eosinophilia; pulmonary eosinophilia with asthma; TPE; and polyarteritis nodosa [1]. In the 21st century, the differential diagnosis of PIE includes asthma, allergic bronchopulmonary aspergillosis, EGPA, HES, parasitic infections, acute eosinophilic pneumonia, CEP, reactions to drugs or toxins and hypereosinophilic obliterative bronchiolitis [2]. The approach to PIE is similar to other respiratory disorders where the importance of a proper history, adequate clinical examination and appropriate analysis of imaging findings cannot be overestimated.…”

Section: Discussionmentioning

confidence: 99%

An interesting case of pulmonary infiltrates with eosinophilia: out of sight out of mind

Panjwani,

Salman,

Nabar

2023

Breathe

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Section: Discussionmentioning

confidence: 99%

An interesting case of pulmonary infiltrates with eosinophilia: out of sight out of mind

Panjwani,

Salman,

Nabar

2023

Breathe

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“…EB is an airway eosinophilic inflammation characterized by eosinophilia in induced sputum, bronchoalveolar lavage (BAL) and endobronchial biopsies, in the absence of bronchial hyper-responsiveness or airflow obstruction. The main symptom is a chronic non-productive cough that responds well to inhaled corticosteroids (ICS) treatment [ 19 ]. For these characteristics, EB can mimic asthma.…”

Section: Asthma In Eosinophilic Diseasesmentioning

confidence: 99%

“…It is characterized by peripheral blood and/or BAL eosinophilia and radiological or histological evidence of bronchiolitis. This rare disease can mimic a form of severe asthma, but in some cases there appears to be an overlap with asthma, HES and other pulmonary eosinophilic diseases [ 19 , 22 ].…”

Section: Asthma In Eosinophilic Diseasesmentioning

confidence: 99%

Hidden Comorbidities in Asthma: A Perspective for a Personalized Approach

Maule

Olivieri

Guarnieri

et al. 2023

JCM

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Bronchial asthma is the most frequent inflammatory non-communicable condition affecting the airways worldwide. It is commonly associated with concomitant conditions, which substantially contribute to its burden, whether they involve the lung or other districts. The present review aims at providing an overview of the recent acquisitions in terms of asthma concomitant systemic conditions, besides the commonly known respiratory comorbidities. The most recent research has highlighted a number of pathobiological interactions between asthma and other organs in the view of a shared immunological background underling different diseases. A bi-univocal relationship between asthma and common conditions, including cardiovascular, metabolic or neurodegenerative diseases, as well as rare disorders such as sickle cell disease, α1-Antitrypsin deficiency and immunologic conditions with hyper-eosinophilia, should be considered and explored, in terms of diagnostic work-up and long-term assessment of asthma patients. The relevance of that acquisition is of utmost importance in the management of asthma patients and paves the way to a new approach in the light of a personalized medicine perspective, besides targeted therapies.

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“…Besides T2 asthma, also chronic urticaria, chronic rhinosinusitis with nasal polyps (CRSwNP), and atopic dermatitis are characterized by T2 inflammation ( Garcovich et al, 2021 ; Matucci et al, 2021 ). While increased blood eosinophils are a biomarker for T2 asthma, a differential diagnosis is extensive and includes CRSwNP, vasculitis, and parasitic disease ( Piggott et al, 2022 ). These eosinophils contribute to innate immune responses against helminths (i.e., multicellular parasitic worms) through phagocytosis, release of cytotoxic proteins and formation of extracellular traps ( Klion, et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Parasitic infections related to anti-type 2 immunity monoclonal antibodies: a disproportionality analysis in the food and drug administration’s adverse event reporting system (FAERS)

Pera,

Brusselle,

Riemann

et al. 2023

Front. Pharmacol.

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Introduction: Monoclonal antibodies (mAbs) targeting immunoglobulin E (IgE) [omalizumab], type 2 (T2) cytokine interleukin (IL) 5 [mepolizumab, reslizumab], IL-4 Receptor (R) α [dupilumab], and IL-5R [benralizumab]), improve quality of life in patients with T2-driven inflammatory diseases. However, there is a concern for an increased risk of helminth infections. The aim was to explore safety signals of parasitic infections for omalizumab, mepolizumab, reslizumab, dupilumab, and benralizumab.Methods: Spontaneous reports were used from the Food and Drug Administration’s Adverse Event Reporting System (FAERS) database from 2004 to 2021. Parasitic infections were defined as any type of parasitic infection term obtained from the Standardised Medical Dictionary for Regulatory Activities® (MedDRA®). Safety signal strength was assessed by the Reporting Odds Ratio (ROR).Results: 15,502,908 reports were eligible for analysis. Amongst 175,888 reports for omalizumab, mepolizumab, reslizumab, dupilumab, and benralizumab, there were 79 reports on parasitic infections. Median age was 55 years (interquartile range 24–63 years) and 59.5% were female. Indications were known in 26 (32.9%) reports; 14 (53.8%) biologicals were reportedly prescribed for asthma, 8 (30.7%) for various types of dermatitis, and 2 (7.6%) for urticaria. A safety signal was observed for each biological, except for reslizumab (due to lack of power), with the strongest signal attributed to benralizumab (ROR = 15.7, 95% Confidence Interval: 8.4–29.3).Conclusion: Parasitic infections were disproportionately reported for mAbs targeting IgE, T2 cytokines, or T2 cytokine receptors. While the number of adverse event reports on parasitic infections in the database was relatively low, resulting safety signals were disproportionate and warrant further investigation.

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Differential diagnosis of pulmonary eosinophilia

Cited by 5 publications

References 127 publications

An interesting case of pulmonary infiltrates with eosinophilia: out of sight out of mind

An interesting case of pulmonary infiltrates with eosinophilia: out of sight out of mind

Hidden Comorbidities in Asthma: A Perspective for a Personalized Approach

Parasitic infections related to anti-type 2 immunity monoclonal antibodies: a disproportionality analysis in the food and drug administration’s adverse event reporting system (FAERS)

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