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{{Eosinophilic pneumonia}}
{{Eosinophilic pneumonia}}
{{CMG}} {{AE}} [[Priyamvada Singh|Priyamvada Singh, M.D.]] [mailto:psingh13579@gmail.com]
{{CMG}} {{AE}} {{MAD}}


==Overview==
==Overview==
Causes of eosinophilic lung diseases are acute eosinophilic pneumonia, chrnoic eosinophilic pneumonia, [[tropical pulmonary eosinophilia]], [[Granulomatosis with polyangiitis|eosinophilic granulomatosis with polyangitis]], [[allergic bronchopulmonary aspergillosis]], and [[medications]] such as [[Non-steroidal anti-inflammatory drug|nonsteroidal anti-inflammatory drugs]], [[Anticonvulsants]], [[Antidepressants]], [[Angiotensin converting enzyme inhibitors]], and [[Beta blockers]].
==Causes==
==Causes==
'''Transpulmonary passage of helminth larvae (Löffler syndrome)'''


Three types of helminths, ''Ascaris (A. lumbricoides'', ''A. suum''), hookworms (''Ancylostoma duodenale'', ''Necator americanus''), and ''Strongyloides stercoralis'', have life cycles in which infecting larvae reach the lungs via the bloodstream, penetrate into alveoli, mature, and ascend the airways before descending the alimentary tract into the small bowel [10].
==== '''Acute eosinophilic pneumonia (AEP)''' ====
* The cause of acute eosinophilic pneumonia is unknown but an acute [[hypersensitivity reaction]] is suggested.<ref name="pmid27514599">{{cite journal| author=Cottin V| title=Eosinophilic Lung Diseases. | journal=Clin Chest Med | year= 2016 | volume= 37 | issue= 3 | pages= 535-56 | pmid=27514599 | doi=10.1016/j.ccm.2016.04.015 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27514599  }}</ref>
'''Chrnoic eosinophilic pneumonia (CEP)'''
* [[Chronic eosinophilic pneumonia]] is an  characterized by an abnormal and marked accumulation of [[eosinophils]] in the [[interstitium]] and alveolar spaces of [[Lung|the lung]].<ref name="pmid29404185">{{cite journal| author=Yıldız T, Dülger S| title=Non-astmatic Eosinophilic Bronchitis. | journal=Turk Thorac J | year= 2018 | volume= 19 | issue= 1 | pages= 41-45 | pmid=29404185 | doi=10.5152/TurkThoracJ.2017.17017 | pmc=5783052 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29404185  }}</ref>


The syndrome of transient pulmonary radiographic opacities and peripheral blood eosinophilia was originally described by Löffler; ''Ascaris'' infection acquired from the use of contaminated human night-soil as fertilizer was determined to be the cause [11]. Subsequent investigations have confirmed that ''Ascaris'' is the most common cause of Löffler syndrome worldwide.  
==== '''Transpulmonary passage of [[Helminth|helminth larvae]] (Löffler syndrome)''' ====
* Three types of helminths, ''[[Ascariasis|Ascaris]]'', [[hookworms]], and ''[[Strongyloides stercoralis]]'', have larvae that reach the lungs, penetrate into [[alveoli]], and ascend the airways then reach the [[gastrointestinal tract]].
* ''[[Ascariasis|Ascaris]]'' is the most common cause of [[Löffler's syndrome|Löffler syndrome]] worldwide.<ref>{{Cite journal


'''Tropical pulmonary eosinophilia'''
| pmid = 13331628
}}</ref><ref name="pmid294693162">{{cite journal| author=Yang Z, Lei W, Xiao-Li L, Xiao-Jun T, Wei L, Yi-Jun A et al.| title=[Clinical features of imported schistosomiasis mansoni in Beijing City：a report of 6 cases]. | journal=Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi | year= 2017 | volume= 29 | issue= 2 | pages= 150-154 | pmid=29469316 | doi=10.16250/j.32.1374.2016207 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29469316  }}</ref>


Tropical pulmonary eosinophilia results from a distinct immune response to the bloodborne microfilarial stages of the lymphatic filariae, Wuchereria bancrofti and, less commonly, Brugia malayi [16-18]. The typical symptoms are cough, breathlessness, wheezing, fatigue, and fever. Pulmonary function tests may show a mixed restrictive and obstructive abnormality with a reduction in diffusion capacity [18]. Chest radiographs typically show diffuse opacities (image 2), although approximately 20 percent of affected patients have a normal chest radiograph [18,19]. CT scans are more sensitive than chest radiography; typical findings include reticular and small nodular opacities, bronchiectasis, air trapping, calcification, and mediastinal adenopathy [18,19].
==== '''Tropical pulmonary eosinophilia''' ====
* [[Tropical pulmonary eosinophilia]] is immune response to the [[Lymphatic filariasis|lymphatic filariae]] and [[Wuchereria bancrofti]].<ref>{{Cite journal


'''EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS''' 
| pmid = 15486834
}}</ref>
* [[Pulmonary function tests]] may show a mixed restrictive and obstructive abnormality with a reduction in [[diffusion capacity]].<ref>{{Cite journal


Eosinophilic granulomatosis with polyangiitis (EGPA, Churg-Strauss) is a vasculitic disorder often characterized by sinusitis, asthma, and prominent peripheral blood eosinophilia [49]. It is the sole form of vasculitis that is associated with both eosinophilia and frequent lung involvement. In addition to the lungs, the skin and the cardiovascular, gastrointestinal, renal, and neurologic systems may also be involved.
| author = [[Jai B. Mullerpattan]], [[Zarir F. Udwadia]] & [[Farokh E. Udwadia]]
| title = Tropical pulmonary eosinophilia--a review
| journal = [[The Indian journal of medical research]]
| volume = 138
| issue = 3
| pages = 295–302
| year = 2013
| month = September
| pmid = 24135173
}}</ref>


'''ALLERGIC BRONCHOPULMONARY ASPERGILLOSIS''' 
==== '''Eosinophilic granulomatosis with polyangitis''' ====
* [[Eosinophilic granulomatosis with polyangiitis]] ([[Churg-Strauss syndrome|Churg-Strauss]]) is a vasculitic disorder often characterized by [[sinusitis]], [[asthma]], and prominent peripheral [[Eosinophilia|blood eosinophilia]].<ref>{{Cite journal


Allergic bronchopulmonary aspergillosis (ABPA) is a complex hypersensitivity reaction that occurs when airways become colonized by ''Aspergillus'' [51]. Repeated episodes of bronchial obstruction, inflammation, and mucoid impaction can lead to bronchiectasis, fibrosis, and respiratory compromise. Immunologic responses elicited by ''Aspergillus fumigatus'' are responsible for this syndrome.
| author = [[L. Guillevin]], [[P. Cohen]], [[M. Gayraud]], [[F. Lhote]], [[B. Jarrousse]] & [[P. Casassus]]
| title = Churg-Strauss syndrome. Clinical study and long-term follow-up of 96 patients
| journal = [[Medicine]]
| volume = 78
| issue = 1
| pages = 26–37
| year = 1999
| month = January
| pmid = 9990352
}}</ref>
* It is the sole form of [[vasculitis]] that is associated with both eosinophilia and frequent lung involvement.
* In addition to the lungs, the skin and the cardiovascular, gastrointestinal, renal, and neurologic systems may also be involved.


==References==
==== '''Allergic bronchopulmonary aspergillosis''' ====
{{reflist|2}}
* [[Allergic bronchopulmonary aspergillosis]] is a complex [[hypersensitivity reaction]] that occurs when airways become colonized by ''[[Aspergillus]].''<ref>{{Cite journal


[[Category:Pulmonology]]
| pmid = 16612769
}}</ref>
* Immunologic responses elicited by ''[[Aspergillus fumigatus]]'' are responsible for this syndrome. It can lead to [[bronchiectasis]], and [[fibrosis]].


[[Category:Emergency medicine]]
==== Drugs and toxins ====
[[Drug reaction with eosinophilia and systemic symptoms]] (DRESS) is a [[Drug-induced hypersensitivity syndrome|drug-induced hypersensitivity reaction]] that includes skin eruption, [[eosinophilia]], [[Atypical lymphocyte|atypical lymphocytosis]], [[lymphadenopathy]], and kidney involvement. Drugs causing DRESS are:<ref>{{Cite journal


| author = [[Peter W. Kim]], [[Alfred F. Sorbello]], [[Ronald T. Wassel]], [[Tracy M. Pham]], [[Joseph M. Tonning]] & [[Sumathi Nambiar]]
| title = Eosinophilic pneumonia in patients treated with daptomycin: review of the literature and US FDA adverse event reporting system reports
| journal = [[Drug safety]]
| volume = 35
| issue = 6
| pages = 447–457
| year = 2012
| month = June
| doi = 10.2165/11597460-000000000-00000
| pmid = 22612850
}}</ref>
* [[Non-steroidal anti-inflammatory drug|Nonsteroidal anti-inflammatory drugs]]
* [[Anticonvulsants]]
* [[Antidepressants]]
* [[Angiotensin converting enzyme inhibitors]]
* [[Beta blockers]]
* [[Hydrochlorothiazide]]
* [[Cocaine]]<ref name="pmid29487790">{{cite journal| author=Reyes F, Vaitkus V, Al-Ajam M| title=A case of cocaine-induced eosinophilic pneumonia: Case report and review of the literature. | journal=Respir Med Case Rep | year= 2018 | volume= 23 | issue=  | pages= 98-102 | pmid=29487790 | doi=10.1016/j.rmcr.2017.12.012 | pmc=5805849 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29487790  }}</ref>


{{WH}}
== References ==
{{WS}}
{{reflist|2}}
[[Category:Pulmonology]]
[[Category:Disease]]

Latest revision as of 18:29, 29 March 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]

Overview

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.

Causes

Acute eosinophilic pneumonia (AEP)

Chrnoic eosinophilic pneumonia (CEP)

Transpulmonary passage of helminth larvae (Löffler syndrome)

Tropical pulmonary eosinophilia

Eosinophilic granulomatosis with polyangitis

Allergic bronchopulmonary aspergillosis

Drugs and toxins

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a drug-induced hypersensitivity reaction that includes skin eruption, eosinophilia, atypical lymphocytosis, lymphadenopathy, and kidney involvement. Drugs causing DRESS are:[9]

References

  1. ↑ Cottin V (2016). "Eosinophilic Lung Diseases". Clin Chest Med. 37 (3): 535–56. doi:10.1016/j.ccm.2016.04.015. PMID 27514599.
  2. ↑ Yıldız T, Dülger S (2018). "Non-astmatic Eosinophilic Bronchitis". Turk Thorac J. 19 (1): 41–45. doi:10.5152/TurkThoracJ.2017.17017. PMC 5783052. PMID 29404185.
  3. ↑ . PMID 13331628. Missing or empty |title= (help)
  4. ↑ Yang Z, Lei W, Xiao-Li L, Xiao-Jun T, Wei L, Yi-Jun A; et al. (2017). "[Clinical features of imported schistosomiasis mansoni in Beijing City：a report of 6 cases]". Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi. 29 (2): 150–154. doi:10.16250/j.32.1374.2016207. PMID 29469316.
  5. ↑ . PMID 15486834. Missing or empty |title= (help)
  6. ↑ Jai B. Mullerpattan, Zarir F. Udwadia & Farokh E. Udwadia (2013). "Tropical pulmonary eosinophilia--a review". The Indian journal of medical research. 138 (3): 295–302. PMID 24135173. Unknown parameter |month= ignored (help)
  7. ↑ L. Guillevin, P. Cohen, M. Gayraud, F. Lhote, B. Jarrousse & P. Casassus (1999). "Churg-Strauss syndrome. Clinical study and long-term follow-up of 96 patients". Medicine. 78 (1): 26–37. PMID 9990352. Unknown parameter |month= ignored (help)
  8. ↑ . PMID 16612769. Missing or empty |title= (help)
  9. ↑ Peter W. Kim, Alfred F. Sorbello, Ronald T. Wassel, Tracy M. Pham, Joseph M. Tonning & Sumathi Nambiar (2012). "Eosinophilic pneumonia in patients treated with daptomycin: review of the literature and US FDA adverse event reporting system reports". Drug safety. 35 (6): 447–457. doi:10.2165/11597460-000000000-00000. PMID 22612850. Unknown parameter |month= ignored (help)
  10. ↑ Reyes F, Vaitkus V, Al-Ajam M (2018). "A case of cocaine-induced eosinophilic pneumonia: Case report and review of the literature". Respir Med Case Rep. 23: 98–102. doi:10.1016/j.rmcr.2017.12.012. PMC 5805849. PMID 29487790.
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