Eosinophilic pneumonia natural history, complications, and prognosis: Difference between revisions

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Revision as of 21:17, 10 February 2018

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

Overview

Natural History

Complications

Chronic prednisone is associated with many side effects, including increased infections, weakened bones, stomach ulcers, and changes in appearance.^[3]

Relapse

RF; Extrapulmonary organ failure or shock is exceptional, and only a couple of lethal cases have been reported. 52,91

Prognosis

some people with CEP require lifelong therapy.
response to corticosteroid treatment is dramatic and treatment always leads to complete resolution, pulmonary function tests return to normal after recovery from the illness [8]. The pleural effusions may resolve more slowly than the pulmonary parenchymal opacities [9].
relapses of ICEP are observed in up to 50% of patients and is usually associated with resumption of cigarette smoking after initial cessation [14,18-20]. [3]
These relapses occur while tapering the dose of corticosteroids or after weaning.

References

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[3]

@@ Line 8: / Line 8: @@
 ==Complications==
+Chronic prednisone is associated with many side effects, including [[Immunosuppression|increased infections]], weakened bones, [[Peptic ulcer|stomach ulcers]], and changes in appearance.{{ref|Naughton}}
-== Prognosis ==
+Relapse
-Eosinophilic pneumonia due to cancer or parasitic infection carries a prognosis related to the underlying illness. AEP and CEP, however, have very little associated mortality as long as [[intensive care]] is available and treatment with corticosteroids is given. CEP often relapses when  [[prednisone]] is discontinued; therefore, some people with CEP require lifelong therapy. Chronic prednisone is associated with many side effects, including [[Immunosuppression|increased infections]], weakened bones, [[Peptic ulcer|stomach ulcers]], and changes in appearance.{{ref|Naughton}}
-Symptomatic and radiographic improvement is usually rapid and progressive with complete radiographic clearing over one to two months after initiation of systemic glucocorticoids [8].
+RF; Extrapulmonary organ failure or shock is exceptional, and only a couple of lethal cases have been reported. 52,91
-Similarly, pulmonary function tests return to normal after recovery from the illness [8].
+== Prognosis ==
+* some people with CEP require lifelong therapy.
-Relapse is uncommon and is usually associated with resumption of cigarette smoking after initial cessation [14,18-20].
+* response to corticosteroid treatment is dramatic and treatment always leads to complete resolution, pulmonary function tests return to normal after recovery from the illness [8]. The pleural effusions may resolve more slowly than the pulmonary parenchymal opacities [9].
+* relapses of ICEP are observed in up to 50% of patients and is usually associated with resumption of cigarette smoking after initial cessation [14,18-20]. [3]
-The pleural effusions may resolve more slowly than the pulmonary parenchymal opacities [9].
+* These relapses occur while tapering the dose of corticosteroids or after weaning.
-Although response to corticosteroid treatment is dramatic
-and treatment always leads to complete resolution,
-relapses of ICEP are observed in up to 50% of patients [3].
-These relapses occur while tapering the dose of corticosteroids
-or after weaning. Relapses remain as responsive to
-corticosteroids as the inaugural episode. Inhaled corticosteroids
-have been proposed in order to prevent relapses
-[7]. This is supported by a lower rate of ICEP relapse in
-asthmatics treated with inhaled corticosteroids [8].
-The development of asthma in the follow-up of ICEP
-patients is a common finding [8]. Up to one third of the
-patients have asthma requiring long-term corticosteroid
-therapy after a diagnosis of ICEP has been made, and
-some patients develop a fixed obstructive pattern on pulmonary
-function tests [8]. Overall, more than half of
-patients affected by ICEP may require long-term oral corticosteroid
-therapy due to either multiple relapses or
-severe asthma [8]. It is thus advisable to recommend
-measures to prevent corticosteroid-induced osteoporosis
-from the start of the treatment.
 ==References==