Eosinophilic Pneumonia



Eosinophilic Pneumonia







Key Facts


Terminology



  • Synonyms



    • Loeffler syndrome


  • Definition



    • Patchy pulmonary infiltrates characterized by presence of eosinophils as main inflammatory component


Etiology/Pathogenesis



  • Parasites


  • Ingestants and inhalants


  • Fungal infections


  • Drug toxicity


  • Unknown etiology


Clinical Issues



  • Presentation





    • Simple (Loeffler syndrome)


    • Tropical


    • Chronic


    • Acute


  • Treatment



    • Depends on etiology of process


  • Prognosis



    • Most patients follow a recovery process


Microscopic Pathology



  • Histological Features



    • Filling of alveolar spaces by eosinophils and macrophages


    • Intraalveolar acellular exudate


    • Eosinophilic intraalveolar necrosis may be present






Eosinophilic pneumonia shows pulmonary parenchyma with a fibrinous intraalveolar exudate image. Note the presence of numerous inflammatory cells in the center of the exudate image.






Higher magnification shows numerous eosinophils image admixed with macrophages. This finding is essential for the diagnosis of eosinophilic pneumonia.


TERMINOLOGY


Synonyms



  • Loeffler syndrome


Definitions



  • Patchy pulmonary infiltrates characterized by the presence of eosinophils as the main inflammatory component


ETIOLOGY/PATHOGENESIS


Causes



  • Parasites



    • Ascaris


    • Filariasis


    • Strongyloides


    • Toxocara


  • Ingestants and inhalants



    • L-tryptophan


    • Cocaine


  • Fungal infections



    • Aspergillus


    • Candida


    • Curvularia


  • Drug toxicity



    • Antibiotics


  • Unknown etiology


CLINICAL ISSUES


Epidemiology



  • Gender



    • Females are more commonly affected in chronic phase


Presentation



  • Symptomatology will depend on type of process



    • Simple (Loeffler syndrome)



      • Self-limited


      • Fleeting pulmonary infiltrates


    • Tropical



      • Fever


      • Cough


      • Dyspnea


    • Chronic



      • Fever


      • Chills


      • Dyspnea


      • Weight loss


      • History of asthma


    • Acute



      • Fever


      • Marked respiratory difficulty


Laboratory Tests



  • Peripheral eosinophilia in chronic phase


  • Elevated IgE in serum in chronic phase


Natural History

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Jul 9, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Eosinophilic Pneumonia

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