Eosinophilic pneumonia

What is it about ?

Eosinophilic pneumonia is a group of diseases that affect the lungs, are associated with inflammation of the lungs and are characterized by a build-up of eosinophils in the tissue of the lungs and most often in the blood as well. Eosinophils are a type of white blood cell involved in the defense against inflammation and allergic reactions.

The classification of eosinophilic pneumonia is as follows:

• Idiopathic eosinophilic pneumonia, of unknown cause. It can occur during a change in smoking habits, after exposure of the respiratory tract to smoke, dust, dirt, etc., but it is far from always. the case. There is an acute form and a chronic form.
• Secondary eosinophilic pneumonia: it has a definite origin. Here are a few examples:
  • Infections with parasites (eg worms), certain bacteria and fungi;
  • Infections during or after irradiation ;
  • Inhalation exposure to toxic substances, such as drugs ;
  • Side effects of medications, such as certain antibiotics, antacids, paracetamol, etc.
• Eosinophilic pneumonia associated with another disease eg. inflammation of the blood vessels (vasculitis), cancer or connective tissue disease.

How to recognize it?

Idiopathic eosinophilic pneumonia

• The acute form develops within a few days in a healthy adult person. Symptoms are fever, cough,shortness of breath and chest pain.
• The chronic form develops slowly, over a few weeks to a few months. The symptoms are the same, but there is tired and an weightloss.
• Hypereosinophilic syndrome: other organs are also affected, such as the heart (heart failure, heart valve disorders, etc.), the nervous system (paralysis, inflammation of the nerves…) and the skin (rash).

Secondary eosinophilic pneumonia

Symptoms can be acute or chronic and are the same as those found in idiopathic forms. The cause (see above) can cause additional symptoms.

Eosinophilic pneumonia associated with other diseases

In this case, the symptoms of the underlying disease are often to the fore, such as cancer or a severe attack.asthma. Response to treatment is often limited.

How is the diagnosis made?

The doctor bases his diagnosis on the one hand on the history of the disease and on the other hand on additional examinations, namely a blood test, an X-ray and / or a CT scan of the lungs, and if necessary a bronchoscopy (endoscopic examination of the bronchi) with flushing of the bronchi. This method collects cells and mucus for examination in the laboratory.

What can the doctor do?

Treatment depends on the cause. It is often based on cortisone. Hospitalization is usually necessary.

Source

Foreign clinical practice guide ‘Eosinophilic pneumonitis’ (2000), updated on 27.11.2015 and adapted to the Belgian context on 01.11.2019 – ebpracticenet