Chronic eosinophilic pneumonia: five cases report_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

YANG Tianyun ¹ ,  HAN Fengfeng ¹ , SONG Lin ¹ , SUN Jinyuan ¹ , PENG Juan ¹ , GUAN Wenbin ² , GUO Xuejun ¹

1. Department of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Xinhua Hospital, Shanghai 200092, P.R.China;
2. Department of Pathology, Shanghai Jiao Tong University School of Medicine Affiliated Xinhua Hospital, Shanghai 200092, P.R.China;

Corresponding author：

HAN Fengfeng, Email: fengfh86@sina.com

Keywords：

Chronic eosinophilic pneumonia; Diagnosis; Treatment; Pathology

DOI：

10.7507/1671-6205.201602005

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ObjectiveTo summarize the clinical manifestations, diagnosis and treatments of chronic eosinophilic pneumonia (CEP).MethodsThe clinical and pathological data of five patients with CEP diagnosed in this hospital between January 2011 and January 2015 were retrospectively analyzed.ResultsThere were five CEP cases including two males and three females, and one case with allergic rhinitis, two cases with bronchial asthma, two cases with allergic history, and one case with allergic skin rash. The main clinical manifestations were fever, cough, expectoration, shortness of breath and chest pain, and often accompanied by fatigue, anorexia and weight loss. The main signs included moist rales, scattered wheeze and crackles. There were significantly increased peripheral blood eosinophils count, the proportion of eosinophils, and the proportion of eosinophils in bronchoalveolar lavage fluid in all five cases. The main imaging features were airway infiltration, real change shadow and ground glass shadow. All of five cases were treated with glucocorticoid, and one of them relapsed during follow-up.ConclusionsThe onset of CEP is insidious. The clinical manifestations of CEP are lack of specificity, and often associate with asthma and allergic dermatitis. Eosinophils significantly increase in peripheral blood and bronchoalveolar lavage fluid in most of CEP patients. The typical image is peripheral and subpleural distribution of lung infiltrates.

Citation： YANG Tianyun, HAN Fengfeng, SONG Lin, SUN Jinyuan, PENG Juan, GUAN Wenbin, GUO Xuejun. Chronic eosinophilic pneumonia: five cases report. Chinese Journal of Respiratory and Critical Care Medicine, 2017, 16(3): 265-270. doi: 10.7507/1671-6205.201602005 Copy

1.	Kolb AG, Ives ST, Davies SF. Diagnosis in just over a minute: a case of chronic eosinophilic pneumonia. J Gen Intern Med, 2013, 28(7): 972-975.
2.	Alam M, Burki NK. Chronic eosinophilic pneumonia: a review. South Med J, 2007, 100(1): 49-53.
3.	Carrington CB, Addington WW, Goff AM, et al. Chronic eosinophilic pneumonia. N Engl J Med, 1969, 280(15): 787-798.
4.	Boudou L, Alexandre C, Thomas T, et al. Chronic eosinophilic pneumonia (Carrington’s disease) and rheumatoid arthritis. Joint Bone Spine, 2010, 77(5): 477-480.
5.	Marchand E, Reynaud-Gaubert M, Lauque D, et al. Idiopathic chronic eosinophilic pneumonia. A clinical and follow-up study of 62 cases. The Groupe d’Etudes et de Recherche sur les Maladies " Orphelines” Pulmonaires (GERM" O”P). Medicine (Baltimore), 1998, 77(5): 299-312.
6.	Jeong YJ, Kim KI, Seo IJ, et al. Eosinophilic lung diseases: a clinical, radiologic, and pathologic overview. Radiographics, 2007, 27(3): 617-639.
7.	Tzilas V, Bastas A, Koti A, et al. A 77 year old male with peripheral eosinophilia, pulmonary infiltrates and a small pleural effusion. Eur Rev Med Pharmacol Sci, 2009, 13(3): 227-232.
8.	Marchand E, Cordier JF. Idiopathic chronic eosinophilic pneumonia. Orphanet J Rare Dis, 2006, 1: 11.
9.	Cottin V, Frognier R, Monnot H, et al. Chronic eosinophilic pneumonia after radiation therapy for breast cancer. Eur Respir J, 2004, 23(1): 9-13.
10.	Solomon J, Schwarz M. Drug-, toxin-, and radiation therapy-induced eosinophilic pneumonia. Semin Respir Crit Care Med, 2006, 27(2): 192-197.
11.	Chaaban S, Salloum V. Chronic eosinophilic pneumonia in a breast cancer patient post-radiation therapy: a case report. Respir Care, 2014, 59(5): e81-e83.
12.	Pornsuriyasak P, Suwatanapongched T, Klaewsongkram J, et al. Acute respiratory failure secondary to eosinophilic pneumonia following influenza vaccination in an elderly man with chronic obstructive pulmonary disease. Int J Infect Dis, 2014, 26: 14-16.
13.	Golstein MA, Steinfeld S. Chronic eosinophilic pneumonia followed by Churg-Strauss syndrome. Rev Rhum Engl Ed, 1996, 63(9): 624-628.
14.	Mochimaru H, Kawamoto M, Fukuda Y, et al. Clinicopathological differences between acute and chronic eosinophilic pneumonia. Respirology, 2005, 10(1): 76-85.
15.	Gaensler EA, Carrington CB. Peripheral opacities in chronic eosinophilic pneumonia: the photographic negative of pulmonary edema. Am J Roentgenol, 1977, 128(1): 1-13.
16.	Ebara H, Ikezoe J, Johkoh T, et al. Chronic eosinophilic pneumonia: evolution of chest radiograms and CT features. J Comput Assist Tomogr, 1994, 18(5): 737-744.
17.	Gholamnejad M, Rezaie N. Unusual presentation of chronic eosinophilic pneumonia with " reversed halo sign”: a case report. Iran J Radiol, 2014, 11(2): e7891.
18.	Campos LE, Pereira LF. Pulmonary eosinophilia. J Bras Pneumol, 2009, 35(6): 561-573.
19.	Toyoshima M, Suda T, Chida K. Tracheobronchial involvement in chronic eosinophilic pneumonia. Am J Respir Crit Care Med, 2012, 186(10): 1057.
20.	Hara J, Nishi K, Demura Y, et al. Chronic eosinophilic pneumonia with endobronchial involvement. J Bronchology Interv Pulmonol, 2011, 18(3): 285-287.
21.	Matsuda Y, Tachibana K, Sasaki Y, et al. Tracheobronchial lesions in eosinophilic pneumonia. Respir Investig, 2014, 52(1): 21-27.
22.	Kim NH, Lee KH, Kim JH, et al. Bronchial involvement in chronic eosinophilic pneumonia: a case report. J Thorac Dis, 2015, 7(4): E97-E101.
23.	Marchand E, Etienne-Mastroianni B, Chanez P, et al. Idiopathic chronic eosinophilic pneumonia and asthma: how do they influence each other?. Eur Respir J, 2003, 22(1): 8-13.
24.	Oyama Y, Fujisawa T, Hashimoto D, et al. Efficacy of short-term prednisolone treatment in patients with chronic eosinophilic pneumonia. Eur Respir J, 2015, 45(6): 1624-1631.
25.	Tani K, Kashio M, Sano N, et al. A case of sarcoidosis associated with chronic eosinophilic pneumonia. J Med Invest, 1998. 45(1-4): 131-136.
26.	Lee JY, Choi H, Chon GR. Allergic bronchopulmonary aspergillosis mimicking relapsing chronic eosinophilic pneumonia in non-asthma patient. Allergol Int, 2014, 63(1): 133-135.
27.	Shin YS, Jin HJ, Yoo HS, et al. Successful treatment of chronic eosinophilic pneumonia with anti-IgE therapy. J Korean Med Sci, 2012, 27(10): 1261-1264.
28.	Kaya H, Gumus S, Ucar E, et al. Omalizumab as a steroid-sparing agent in chronic eosinophilic pneumonia. Chest, 2012, 142(2): 513-516.

1. Kolb AG, Ives ST, Davies SF. Diagnosis in just over a minute: a case of chronic eosinophilic pneumonia. J Gen Intern Med, 2013, 28(7): 972-975.
2. Alam M, Burki NK. Chronic eosinophilic pneumonia: a review. South Med J, 2007, 100(1): 49-53.
3. Carrington CB, Addington WW, Goff AM, et al. Chronic eosinophilic pneumonia. N Engl J Med, 1969, 280(15): 787-798.
4. Boudou L, Alexandre C, Thomas T, et al. Chronic eosinophilic pneumonia (Carrington’s disease) and rheumatoid arthritis. Joint Bone Spine, 2010, 77(5): 477-480.
5. Marchand E, Reynaud-Gaubert M, Lauque D, et al. Idiopathic chronic eosinophilic pneumonia. A clinical and follow-up study of 62 cases. The Groupe d’Etudes et de Recherche sur les Maladies " Orphelines” Pulmonaires (GERM" O”P). Medicine (Baltimore), 1998, 77(5): 299-312.
6. Jeong YJ, Kim KI, Seo IJ, et al. Eosinophilic lung diseases: a clinical, radiologic, and pathologic overview. Radiographics, 2007, 27(3): 617-639.
7. Tzilas V, Bastas A, Koti A, et al. A 77 year old male with peripheral eosinophilia, pulmonary infiltrates and a small pleural effusion. Eur Rev Med Pharmacol Sci, 2009, 13(3): 227-232.
8. Marchand E, Cordier JF. Idiopathic chronic eosinophilic pneumonia. Orphanet J Rare Dis, 2006, 1: 11.
9. Cottin V, Frognier R, Monnot H, et al. Chronic eosinophilic pneumonia after radiation therapy for breast cancer. Eur Respir J, 2004, 23(1): 9-13.
10. Solomon J, Schwarz M. Drug-, toxin-, and radiation therapy-induced eosinophilic pneumonia. Semin Respir Crit Care Med, 2006, 27(2): 192-197.
11. Chaaban S, Salloum V. Chronic eosinophilic pneumonia in a breast cancer patient post-radiation therapy: a case report. Respir Care, 2014, 59(5): e81-e83.
12. Pornsuriyasak P, Suwatanapongched T, Klaewsongkram J, et al. Acute respiratory failure secondary to eosinophilic pneumonia following influenza vaccination in an elderly man with chronic obstructive pulmonary disease. Int J Infect Dis, 2014, 26: 14-16.
13. Golstein MA, Steinfeld S. Chronic eosinophilic pneumonia followed by Churg-Strauss syndrome. Rev Rhum Engl Ed, 1996, 63(9): 624-628.
14. Mochimaru H, Kawamoto M, Fukuda Y, et al. Clinicopathological differences between acute and chronic eosinophilic pneumonia. Respirology, 2005, 10(1): 76-85.
15. Gaensler EA, Carrington CB. Peripheral opacities in chronic eosinophilic pneumonia: the photographic negative of pulmonary edema. Am J Roentgenol, 1977, 128(1): 1-13.
16. Ebara H, Ikezoe J, Johkoh T, et al. Chronic eosinophilic pneumonia: evolution of chest radiograms and CT features. J Comput Assist Tomogr, 1994, 18(5): 737-744.
17. Gholamnejad M, Rezaie N. Unusual presentation of chronic eosinophilic pneumonia with " reversed halo sign”: a case report. Iran J Radiol, 2014, 11(2): e7891.
18. Campos LE, Pereira LF. Pulmonary eosinophilia. J Bras Pneumol, 2009, 35(6): 561-573.
19. Toyoshima M, Suda T, Chida K. Tracheobronchial involvement in chronic eosinophilic pneumonia. Am J Respir Crit Care Med, 2012, 186(10): 1057.
20. Hara J, Nishi K, Demura Y, et al. Chronic eosinophilic pneumonia with endobronchial involvement. J Bronchology Interv Pulmonol, 2011, 18(3): 285-287.
21. Matsuda Y, Tachibana K, Sasaki Y, et al. Tracheobronchial lesions in eosinophilic pneumonia. Respir Investig, 2014, 52(1): 21-27.
22. Kim NH, Lee KH, Kim JH, et al. Bronchial involvement in chronic eosinophilic pneumonia: a case report. J Thorac Dis, 2015, 7(4): E97-E101.
23. Marchand E, Etienne-Mastroianni B, Chanez P, et al. Idiopathic chronic eosinophilic pneumonia and asthma: how do they influence each other?. Eur Respir J, 2003, 22(1): 8-13.
24. Oyama Y, Fujisawa T, Hashimoto D, et al. Efficacy of short-term prednisolone treatment in patients with chronic eosinophilic pneumonia. Eur Respir J, 2015, 45(6): 1624-1631.
25. Tani K, Kashio M, Sano N, et al. A case of sarcoidosis associated with chronic eosinophilic pneumonia. J Med Invest, 1998. 45(1-4): 131-136.
26. Lee JY, Choi H, Chon GR. Allergic bronchopulmonary aspergillosis mimicking relapsing chronic eosinophilic pneumonia in non-asthma patient. Allergol Int, 2014, 63(1): 133-135.
27. Shin YS, Jin HJ, Yoo HS, et al. Successful treatment of chronic eosinophilic pneumonia with anti-IgE therapy. J Korean Med Sci, 2012, 27(10): 1261-1264.
28. Kaya H, Gumus S, Ucar E, et al. Omalizumab as a steroid-sparing agent in chronic eosinophilic pneumonia. Chest, 2012, 142(2): 513-516.

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