Eosinophilic pneumonia other diagnostic studies: Difference between revisions
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==Overview== | ==Overview== | ||
==Other diagnostic studies== | ==Other diagnostic studies== | ||
'''Bronchoscopy with bronchoalveolar lavage''' | |||
* BAL is performed in the majority of patients to quantitate eosinophilia and to exclude infection, hemorrhage, or malignancy (eg, germ cell tumor, leukemia). | |||
* The BAL is performed using a sequential instillation and recovery of 50 to 60 mL aliquots (to evaluate for hemorrhage) in an area of radiographic opacity. Samples are sent for cell count, microbiologic studies, and cytology. | |||
* In AEP, the BAL fluid typically shows a very high proportion (>25 percent) and total number of eosinophils [8,9,36,41,42]. | |||
* While data on other cell counts are limited, the proportion of BAL lymphocytes is approximately 10 to 30 percent and the proportion of BAL neutrophils is 1 to 16 percent [9,14,19,26]. | |||
* The level of eosinophilia returns to normal when the illness resolves [9,41,42]. | |||
'''Lung biopsy''' | |||
* Lung biopsy is rarely necessary to make a diagnosis of AEP in immunocompetent patients with a compatible history and prominent BAL eosinophilia in the absence of infection or other known precipitant [7,8,62]. | |||
* Indications for lung biopsy would include concern about an infectious etiology that could not be quickly excluded by BAL or failure to respond to systemic glucocorticoids. | |||
==References== | ==References== | ||
Revision as of 16:18, 9 February 2018
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Eosinophilic pneumonia Microchapters |
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Risk calculators and risk factors for Eosinophilic pneumonia other diagnostic studies |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Other diagnostic studies
Bronchoscopy with bronchoalveolar lavage
- BAL is performed in the majority of patients to quantitate eosinophilia and to exclude infection, hemorrhage, or malignancy (eg, germ cell tumor, leukemia).
- The BAL is performed using a sequential instillation and recovery of 50 to 60 mL aliquots (to evaluate for hemorrhage) in an area of radiographic opacity. Samples are sent for cell count, microbiologic studies, and cytology.
- In AEP, the BAL fluid typically shows a very high proportion (>25 percent) and total number of eosinophils [8,9,36,41,42].
- While data on other cell counts are limited, the proportion of BAL lymphocytes is approximately 10 to 30 percent and the proportion of BAL neutrophils is 1 to 16 percent [9,14,19,26].
- The level of eosinophilia returns to normal when the illness resolves [9,41,42].
Lung biopsy
- Lung biopsy is rarely necessary to make a diagnosis of AEP in immunocompetent patients with a compatible history and prominent BAL eosinophilia in the absence of infection or other known precipitant [7,8,62].
- Indications for lung biopsy would include concern about an infectious etiology that could not be quickly excluded by BAL or failure to respond to systemic glucocorticoids.