<p>Chronic eosinophilic pneumonia: clinical perspectives</p>

Abstract

Chronic eosinophilic pneumonia (CEP) is an eosinophilic lung disease that is typically diagnosed by a triad of clinical symptoms including pulmonary symptoms, eosinophilia and characteristic radiographic abnormalities. It requires a high index of suspicion given its overlap with other eosinophilic conditions and lack of a specific diagnostic test. The diagnosis is made after careful consideration of other secondary causes of eosinophilia, such as infectious, drugs, or toxic etiologies. CEP generally responds rapidly to treatment, which primarily consists of corticosteroid therapy, but relapses are common. Novel therapies are being explored as more information is being discovered about the pathophysiology of eosinophilic disease processes. Close follow-up is important given the difficulty in weaning patients from glucocorticoids with many patients developing sequelae of chronic glucocorticoid therapy. Therefore, exploring alternative treatments is of upmost importance.

Treatment and relapse of interstitial lung disease in nivolumab‐treated patients with non–small cell lung cancer

“…13,14 Furthermore, it is known that patients who have ILD and radiographic images with a cryptogenic organizing pneumonia or chronic eosinophilic pneumonia (COP/CEP)-like pattern often experience a relapse, particularly when corticosteroid doses are tapered or discontinued. [15][16][17] In this study, many patients who experienced a relapse had a COP/CEPlike pattern at initial ILD, suggesting that this relationship between a COP/CEP-like pattern and relapse may also be true in nivolumabinduced ILD. Therefore, it may be particularly important to monitor patients with COP/CEP-like patterns carefully, taking into consideration that they may be prone to a relapse when corticosteroid treatment is being discontinued.…”

“…This may be explained by the sustained immunostimulant effect of nivolumab 13,14 . Furthermore, it is known that patients who have ILD and radiographic images with a cryptogenic organizing pneumonia or chronic eosinophilic pneumonia (COP/CEP)–like pattern often experience a relapse, particularly when corticosteroid doses are tapered or discontinued 15‐17 . In this study, many patients who experienced a relapse had a COP/CEP‐like pattern at initial ILD, suggesting that this relationship between a COP/CEP‐like pattern and relapse may also be true in nivolumab‐induced ILD.…”

Mepolizumab and dupilumab as a replacement to systemic glucocorticoids for the treatment of Chronic Eosinophilic Pneumonia and Allergic Bronchopulmonary Aspergillosis - Case series, Almoosa specialist hospital

“…In recent years, several studies and case reports have demonstrated the efficacy of anti-IgE antibodies and interleukin-5/interleukin-5 receptor-alpha (IL5/IL5-Rα) antibodies in the treatment of ABPA but was more beneficial for patients with asthma than for patients with CF [ [29] , [30] , [31] , [32] ]. Mepolizumab has been successfully used to treat patients with ABPA, showing improvement in FEV1, radiographic findings, decrease in total IgE levels, and quality of life without side effects and is considered a glucocorticoid-sparing agent [ [29] , [33] , [34] , [35] , [36] , [37] , [38] , [39] ].…”

Mepolizumab: an alternative therapy for idiopathic chronic eosinophilic pneumonia with glucocorticoid intolerance

“…The phenomenon of hypereosinophilia demonstrates a direct histopathological infiltration and damage of the pulmonary interstitium. 10 Additionally, eosinophil-induced release of interferon-gamma appears to cause collagen deposition and fibrosis completely independent of lymphocytic proliferation of classical tissue remodeling. 11 Interleukins mediate the proliferation and maturation of eosinophils, which are the underlying pathological entity in ICEP and other eosinophilic diseases.…”