Eosinophilic pneumonia overview
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Editor(s)-in-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Priyamvada Singh, M.D. [2]
Overview
Eosinophilic pneumonia (EP) is a disease in which a certain type of white blood cell called an eosinophil accumulates in the lung. These cells cause disruption of the normal air spaces (alveoli) where oxygen is extracted from the atmosphere. Several different kinds of eosinophilic pneumonia exist and can occur in any age group. The most common symptoms include cough, fever, difficulty breathing, and sweating at night. EP is diagnosed by a combination of characteristic symptoms, findings on a physical examination by a health provider, and the results of blood tests and x-rays. Prognosis is excellent once most EP is recognized and treatment with corticosteroids is begun.
Historical Perspective
In 1944, Hamman described a group of four otherwise healthy patients who developed progressive lung disease, known as Hamman-Rich syndrome. In 1989, Acute eosinophilic pneumonia was first described by Badesch and colleagues. In 1969, Carrington was the first to describe chronic eosinophilic pneumonia and known as Carrington syndrome.
Classification
Eosinophilic lung diseases may be classified according to the cause into; pneumonias of unknown cause such as idiopathic chronic eosinophilic pneumonia and idiopathic acute eosinophilic pneumonia, pneumonias of known cause such as allergic bronchopulmonary aspergillosis and eosinophilic pneumonias of parasitic origin, and eosinophilic airways diseases such as hypereosinophilic asthma and idiopathic hypereosinophilic constrictive bronchiolitis.
Pathophysiology
Causes
Causes of eosinophilic lung diseases are acute eosinophilic pneumonia, chrnoic eosinophilic pneumonia, tropical pulmonary eosinophilia, eosinophilic granulomatosis with polyangitis, allergic bronchopulmonary aspergillosis, and medications such as nonsteroidal anti-inflammatory drugs, Anticonvulsants, Antidepressants, Angiotensin converting enzyme inhibitors, and Beta blockers.
Differentiating from other Diseases
Epidemiology and Demographics
The prevalence of idiopathic chronic eosinophilic pneumonia (ICEP) remains unknown. The incidence of chronic eosinophilic pneumonia in an Icelandic registry was 0.23 cases/100,000 population per year between 1990 and 2004. ICEP has been reported to contribute to 0 to 2500 per 100,000 of cases included in different registries of interstitial lung diseases. There is no racial predilection to ICEP. Women are more commonly affected by ICEP than men. ICEP typically affects patients in their 30s or 40s.
Risk Factors
Risk factors for eosinophilic pneumonia vary according to the type; acute pneumonia is related to the recent initiation of tobacco smoking. One third to one-half of the chronic pneumonia patients have a history of asthma.
Screening
There is no specific screening for eosinophilic pneumonia.
Natural History, Complications and Prognosis
If left untreated, patients with eosinophilic pneumonia may progress to develop dyspnea, pleural effusion, and respiratory failure. Common complications of eosinophilic pneumonia include respiratory failure, relapse, and adverse effects of steroids. Prognosis is generally excellent, and only a couple of lethal cases have been reported.