Eosinophilic pneumonia: Difference between revisions

Jump to navigation Jump to search
← Older edit
VisualWikitext
Priyamvada Singh (talk | contribs)
nocaptcha
14,413 edits
Ahmed Younes (talk | contribs)
nocaptcha
6,168 edits
No edit summary
 
(28 intermediate revisions by 6 users not shown)
Line 1: Line 1:
[[Image:Streptococcus pneumoniae.jpg|right|200px]]
__NOTOC__
__NOTOC__
{{Infobox Disease |
  Name          = Pneumonia |
  Image          = |
  Caption        = |
  DiseasesDB    = 10166 |
  ICD10          = {{ICD10|J|12||j|09}}, {{ICD10|J|13||j|09}}, {{ICD10|J|14||j|09}}, {{ICD10|J|15||j|09}}, {{ICD10|J|16||j|09}}, {{ICD10|J|17||j|09}}, {{ICD10|J|18||j|09}}, {{ICD10|P|23||p|20}} |
  ICD9          = {{ICD9|480}}-{{ICD9|486}}, {{ICD9|770.0}} |
  ICDO          = |
  OMIM          = |
  MedlinePlus    = |
  MeshName      = Pneumonia |
  MeshNumber    = C08.381.677 |
}}
{{Eosinophilic pneumonia}}
{{Eosinophilic pneumonia}}


'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
'''For the main page on pneumonia, click [[Pneumonia|here]]


'''Editor(s)-in-Chief:''' [[C. Michael Gibson, M.S., M.D.]] [mailto:mgibson@perfuse.org] Phone:617-632-7753; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.D.]] [mailto:psingh@perfuse.org]; [[Philip Marcus, M.D., M.P.H.]][mailto:pmarcus192@aol.com]
'''Editor(s)-in-Chief:''' [[C. Michael Gibson, M.S., M.D.]] [mailto:charlesmichaelgibson@gmail.com] {{AE}} [[Priyamvada Singh|Priyamvada Singh, M.D.]] [mailto:psingh13579@gmail.com]; [[Philip Marcus, M.D., M.P.H.]][mailto:pmarcus192@aol.com]


==[[Eosinophilic pneumonia overview|Overview]]==
==[[Eosinophilic pneumonia overview|Overview]]==


==[[Pneumonia historical perspective|Historical Perspective]]==  
==[[Eosinophilic pneumonia historical perspective|Historical Perspective]]==  


==[[Pneumonia pathophysiology|Pathophysiology]]==
==[[Eosinophilic pneumonia classification|Classification]]==


==[[Pneumonia causes|Causes]]==
==[[Eosinophilic pneumonia pathophysiology|Pathophysiology]]==


==[[Pneumonia differential diagnosis|Differentiating Pneumonia from other Diseases]]==
==[[Eosinophilic pneumonia causes|Causes]]==


==[[Pneumonia epidemiology and demographics|Epidemiology and Demographics]]==
==[[Eosinophilic pneumonia differential diagnosis|Differentiating Eosinophilic pneumonia from Other Diseases]]==


==[[Pneumonia risk factors|Risk factors]]==
==[[Eosinophilic pneumonia epidemiology and demographics|Epidemiology and Demographics]]==


==[[Pneumonia natural history, complications, and prognosis|Natural History, Complications and Prognosis]]==
==[[Eosinophilic pneumonia risk factors|Risk factors]]==
'''Prognosis predictor scores:''' [[CURB-65]] | [[Pneumonia severity index]] | [[Pneumonia medical therapy#Criteria for severe community acquired pneumonia|Criteria for severe community acquired pneumonia]]
 
==[[Eosinophilic pneumonia screening|Screening]]==
 
==[[Eosinophilic pneumonia natural history, complications, and prognosis|Natural History, Complications and Prognosis]]==


==Diagnosis==  
==Diagnosis==  


[[Pneumonia diagnostic criteria | Diagnostic criteria]] | [[Pneumonia history and symptoms| History and Symptoms]] | [[Pneumonia physical examination | Physical Examination]] | [[Pneumonia laboratory studies |Laboratory Findings]] | [[Pneumonia chest x ray|Chest X Ray]]
[[Eosinophilic pneumonia diagnostic criteria | Diagnostic Criteria]] | [[Eosinophilic pneumonia history and symptoms| History and Symptoms]] | [[Eosinophilic pneumonia physical examination | Physical Examination]] | [[Eosinophilic pneumonia laboratory tests |Laboratory Findings]] | [[Eosinophilic pneumonia chest x ray|Chest X Ray]] | [[Eosinophilic pneumonia CT|CT]] | [[Eosinophilic pneumonia other imaging findings|Other Imaging Findings]] | [[Eosinophilic pneumonia other diagnostic studies|Other Diagnostic Studies]]


==Treatment==
==Treatment==


[[Pneumonia medical therapy#Pneumonia site of care decision|Site of care decision]] | [[Pneumonia medical therapy|Medical Therapy]] | [[Pneumonia medical therapy#Other treatments consideration|Other treatments consideration]] | [[Pneumonia prevention|Prevention]] | [[Pneumonia medical therapy#Management of non-responding pneumonia|Management of non-responding pneumonia]]
[[Eosinophilic pneumonia medical therapy|Medical Therapy]] | [[Eosinophilic pneumonia surgery|Surgery]] | [[Eosinophilic pneumonia prevention|Prevention]] | [[Eosinophilic pneumonia cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Eosinophilic pneumonia future or investigational therapies|Future or Investigational Therapies]]
[[Category:Diseaase]]
[[Category:Pulmonology]]
[[Category:Infectious disease]]
[[Category:Pneumonia|Pneumonia]]
[[Category:Emergency medicine]]


{{WH}}
==Case Studies==
{{WS}}
[[Eosinophilic pneumonia case study one|Case #1]]


 
==Related Chapters==
 
*[[Asthma]]
 
*[[Parasitic pneumonia]]
 
*[[Pneumonia]]
 
 
 
 
== Diagnosis ==
Eosinophilic pneumonia is diagnosed in one of three circumstances: when a [[complete blood count]] reveals increased eosinophils and a chest [[x-ray]] or [[computed tomography]] (CT) identifies abnormalities in the lung, when a [[biopsy]] identifies increased eosinophils in lung tissue, or when increased eosinophils are found in fluid obtained by a [[bronchoscopy]] (bronchoalveolar lavage (BAL) fluid). Association with medication or cancer is usually apparent after review of a person's medical history. Specific parasitic infections are diagnosed after examining a person's exposure to common parasites and performing laboratory tests to look for likely causes. If no underlying cause is found, a diagnosis of AEP or CEP is made based upon the following criteria. AEP is most likely with respiratory failure after an acute febrile illness of  usually less than one week, changes in multiple areas and fluid in the [[pleural cavity|area surrounding the lungs]] on a chest x-ray, and greater than 25% eosinophils on a BAL. Other typical laboratory abnormalities include an elevated [[white blood cell]] count, [[erythrocyte sedimentation rate]], and [[immunoglobulin E]] level. [[spirometry|Pulmonary function testing]] usually reveals a restrictive process with reduced [[diffusion capacity]] for carbon monoxide. CEP is most likely when the symptoms have been present for more than a month. Laboratory tests typical for CEP include increased blood eosinophils, a high erythrocyte sedimentation rate, [[iron deficiency anemia]], and increased [[platelets]]. A chest x-ray can show abnormalities anywhere, but the most specific finding is increased shadow in the periphery of the lung, away from the heart.
 
== Treatment ==
When eosinophilic pneumonia is related to an illness such as cancer or parasitic infection, treatment of the underlying cause is effective in resolving the lung disease. When due to AEP or CEP, however, treatment with [[corticosteroid]]s results in a rapid, dramatic resolution of symptoms over the course of one or two days. Either [[intravenous]] [[methylprednisolone]] or oral [[prednisone]] are most commonly used. In AEP, treatment is usually continued for a month after symptoms disappear and the x-ray returns to normal (usually four weeks total). In CEP, treatment is usually continued for three months after symptoms disappear and the x-ray returns to normal (usually four months total). Inhaled steroids such as [[fluticasone]] have been used effectively when discontinuation of oral prednisone has resulted in [[relapse]].{{ref|Jantz}}
 
Because EP affects the lungs, individuals with EP have difficulty breathing. If enough of the lung is involved, it may not be possible for a person to breathe enough to live without support. Non-invasive machines such as a [[bilevel positive airway pressure]] machine may be used. Otherwise, placement of a [[endotracheal tube|breathing tube]] into the mouth may be necessary and a [[ventilator]] may be used to help the person breathe.
 
== Prognosis ==
Eosinophilic pneumonia due to cancer or parasitic infection carries a prognosis related to the underlying illness. AEP and CEP, however, have very little associated mortality as long as [[intensive care]] is available and treatment with corticosteroids is given. CEP often relapses when  [[prednisone]] is discontinued; therefore, some people with CEP require lifelong therapy. Chronic prednisone is associated with many side effects, including [[Immunosuppression|increased infections]], weakened bones, [[Peptic ulcer|stomach ulcers]], and changes in appearance.{{ref|Naughton}}
 
== Epidemiology ==
Eosinophilic pneumonia is a rare disease. Parasitic causes are most common in geographic areas where each parasite is [[Endemic (ecology)|endemic]]. AEP can occur at any age, even in previously healthy children, though most patients are between 20 and 40 years of age. Men are affected approximately twice as frequently as women. AEP has been associated with [[Tobacco smoking|smoking]]. CEP occurs more frequently in women than men does not appear to be related to smoking. An association with radiation for [[breast cancer]] has been described.{{ref|Cottin}}
 
=== History ===
Chronic eosinophilic pneumonia was first described by Carrington in [[1969]], and it is also known as '''Carrington syndrome'''. Prior to that, eosinophilic pneumonia was a well described pathologic entity usually associated with medication or parasite exposures. Acute eosinophilic pneumonia was first described in [[1989]]{{ref|Badesch}}{{ref|Allen}}.


== References ==
== References ==
Line 90: Line 54:
#{{note|Allen}} Allen, JN, Pacht, ER, Gadek, JE, et al. ''Acute eosinophilic pneumonia as a reversible cause of noninfectious respiratory failure''. N Engl J Med 1989; 321:569.
#{{note|Allen}} Allen, JN, Pacht, ER, Gadek, JE, et al. ''Acute eosinophilic pneumonia as a reversible cause of noninfectious respiratory failure''. N Engl J Med 1989; 321:569.


== See also ==
[[Category:Pulmonology]]
*[[Pneumonia]]
*[[Asthma]]
*[[Parasitic pneumonia]]
 
== References ==
{{reflist|2}}


[[Category:Diseaase]]
[[Category:Pulmonology]]
[[Category:Infectious disease]]
[[Category:Pneumonia|Pneumonia]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]


{{WH}}
{{WH}}
{{WS}}
{{WS}}

Latest revision as of 21:33, 27 March 2018

Pneumonia Main Page

Eosinophilic pneumonia Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Eosinophilic pneumonia from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

CT

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Eosinophilic pneumonia On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Eosinophilic pneumonia

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Eosinophilic pneumonia

CDC onEosinophilic pneumonia

Eosinophilic pneumonia in the news

Blogs on Eosinophilic pneumonia

Directions to Hospitals Treating Eosinophilic pneumonia

Risk calculators and risk factors for Eosinophilic pneumonia

For the main page on pneumonia, click here

Editor(s)-in-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Priyamvada Singh, M.D. [2]; Philip Marcus, M.D., M.P.H.[3]

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Eosinophilic pneumonia from Other Diseases

Epidemiology and Demographics

Risk factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria | History and Symptoms | Physical Examination | Laboratory Findings | Chest X Ray | CT | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Related Chapters

References

  1. ^ Bain, GA, Flower, CD. Pulmonary eosinophilia. Eur J Radiol 1996; 23:3. PMID 8872069
  2. ^ Rom, WN, Weiden, M, Garcia, R, et al. Acute eosinophilic pneumonia in a New York City firefighter exposed to World Trade Center dust. Am J Respir Crit Care Med 2002; 166:797. PMID 12231487
  3. ^ Weller, PF. Parasitic pneumonias. In: Respiratory infections: Diagnosis and management, 3rd ed, Pennington, JE (Ed), Raven Press, New York, 1994, p. 695.
  4. ^ Jantz, MA, Sahn, SA. Corticosteroids in acute respiratory failure. Am J Respir Crit Care Med 1999; 160:1079. PMID 10508792
  5. ^ Naughton, M, Fahy, J, FitzGerald, MX. Chronic eosinophilic pneumonia. A longterm followup of 12 patients. Chest 1993; 103:162. PMID 8031327
  6. ^ Cottin, V, Frognier, R, Monnot, H, et al. Chronic eosinophilic pneumonia after radiation therapy for breast cancer. Eur Respir J 2004; 23:9
  7. ^ Carrington CB, Addington WW, Goff AM, et al. Chronic eosinophilic pneumonia. N Engl J Med 1969;280:788 -798 PMID 5773637
  8. ^ Badesch, DB, King, TE Jr, Schwarz, MI. Acute eosinophilic pneumonia: a hypersensitivity phenomenon?. Am Rev Respir Dis 1989; 139:249.
  9. ^ Allen, JN, Pacht, ER, Gadek, JE, et al. Acute eosinophilic pneumonia as a reversible cause of noninfectious respiratory failure. N Engl J Med 1989; 321:569.

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Eosinophilic_pneumonia&oldid=1457095"