Chronic Eosinophilic Pneumonia

Chronic Eosinophilic pneumonia

Chronic eosinophilic pneumonia (CEP) is a disease typified by an abnormal increase and accumulation of a type of blood cells called eosinophils in the lungs.  ^[1] Usually it is insidious and the cause is unknown. ^[2]

Epidemiology

Affected people are mostly in the middle age range. About half are previously diagnosed with asthma. Females are more likely to have the disease. ^[2]

Causes

The actual mechanism by which eosinophils accumulate in the lungs is still a matter of research. Some medications however are implicated to cause the disease including penicillin, carbamazepine, naproxen, isoniazid, aminosalcylic acid and sulfonamide drugs. Parasites and fungi are also being associated with the condition. ^[3]

Signs and Symptoms

 An affected individual may have cough, wheezes and shortness of breath. CEP is different from the acute type since in the acute one, respiratory failure may ensue in just a couple of days whereas CEP develops over weeks to months. If the person is not treated timely and properly, the shortness of breath experienced can be fatal. ^[3] Some people may develop a rash that is very itchy while others may have symptoms similar to that of sinusitis or rhinitis. Patients with parasitic infection particularly Schistosoma may have distended abdomen, swelling of the extremities, yellowing of the eyes and skin or signs of pulmonary hypertension. ^[4]

Diagnosis

Medical history is important to make a diagnosis or suspect CEP. This includes for instance the appearance of symptoms shortly after taking a drug or travel to an area where fungal or parasitic exposure is probable. ^[3] Laboratory exams that may be requested include blood, stool, urine and sputum exam. Imaging studies like chest radiography and echocardiography are helpful as well. ^[4]

Treatment

Some cases may be mild and may not need any intervention at all as the disease may spontaneously resolve. Steroids such as prednisone may be given in some cases for a long period usually in a period of months to years. When there is wheezing, the patient may be prescribed medications similar to that of asthmatic patients. If the cause is determined to be parasitic, proper drug is given. When a certain medication is thought to be causing the disease, that drug is often discontinued. ^[3] The long-term outlook for CEP is regarded excellent. ^[2]

References:

1.      http://www.uptodate.com/contents/treatment-of-chronic-eosinophilic-pneum  b  onia

2.      http://radiopaedia.org/articles/chronic-eosinophilic-pneumonia

3.      http://www.merckmanuals.com/home/lung_and_airway_disorders/allergic_and_autoimmune_diseases_of_the_lungs/eosinophilic_pneumonia.html

4.      http://emedicine.medscape.com/article/301070-clinical#a0217

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