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Eosinophilic pneumonia induced by drugs
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
Simple pulmonary eosinophilia, or Löffler’s syndrome, causes minimal or no pulmonary symptoms and transient, often migratory, radiographic infiltrates. Chronic eosinophilic pneumonia presents with weeks or months of progressive respiratory symptoms, diffuse or peripheral radiographic infiltrates, and increased blood eosinophils.6 Acute eosinophilic pneumonia presents with sudden onset of respiratory failure and usually lacks blood eosinophilia.7 Churg–Strauss syndrome presents with asthma, blood eosinophilia and granulomatous vasculitis involving the lung and other organs.8 Idiopathic hypereosinophilic syndrome presents with profound blood eosinophilia (generally greater than 1500/mm3) for more than 6 months; many organs, including the lung, may become infiltrated with eosinophils.9 Other diseases that can present as eosinophilic lung disease include fungal infections (especially aspergillosis and coccidioidomycosis), parasitic infections, interstitial lung diseases, allergic bronchopulmonary aspergillosis, bronchocentric granulomatosis and malignancy.
A comprehensive summary of disease variants implicated in metal allergy
Published in Journal of Toxicology and Environmental Health, Part B, 2022
Another inflammatory response of the airways that has been associated with inhalation of allergenic metals is pulmonary eosinophilia. Pulmonary eosinophilia encompasses several distinctive disorders, wherein the primary presentation of disease is increased influx of eosinophils to the respiratory tract and subsequent development of localized inflammation that can result from both hypersensitivity-mediated mechanisms, as well as non-allergic processes (Scott and Wardlaw 2006). Although eosinophilic inflammation is a cardinal sign of allergic asthma, rhinitis, and other chronic lung conditions, pulmonary eosinophilia generally refers to eosinophil-driven airway inflammation that occurs independently of these diseases. Accordingly, the diagnostic criteria used to identify cases of pulmonary eosinophilia generally include a BAL/sputum eosinophil count of > 2.5% of total cells, in addition to the absence of prototypical symptoms associated with other lung conditions like asthma (e.g., AHR, bronchoconstriction, mucus hypersecretion) (Gibson, Fujimura, and Niimi 2002). Two of the most common forms of pulmonary eosinophilia are eosinophilic bronchitis and eosinophilic pneumonia, which produce symptoms ranging from cough, dyspnea, fever, and blood eosinophilia (Akuthota and Weller 2012; Brightling 2006; Pala, Pignatti, and Moscato 2012; Yıldız and Dülger 2018).