Eosinophilic Pneumonia

Posted by e-Medical PPT
Eosinophilic pneumonia – infiltration of lung parenchyma by eosinophilsEosinophil – a PMN that has granules that release major basic protein, eosinophil cationic protein, eosinophil-derived neurotoxin, eosinophilic peroxidase, arachidonic acid products, ROS
Pro-inflammatory cell that purported to attack parasites
Maturation regulated by IL-5 (differentiaion of eosinophil precursors), IL-3, and GM-CSF
Activation:  Eosinophils circulate in blood for 1 day, before being attracted into target tissues
Adhesion, attraction, diapedesis, chemotaxis
Helper T cells also regulate its activity, and it interacts with other myeloid cells (mast cells, fibroblasts, platelets, etc)

Characteristics
Cough, dyspnea, chest pain
Systemic sxs – fatigue, malaise, f/c/ns
PE – wheezing, crackles
CBC – eosinophilia ; elevated ESR
CXR – bilateral infiltrates
CT scan – ground glass opacity and/or consolidation
**BAL

eosinophilic pneumonia can be caused by:
Parasites
other infections (fungi, yeast)
ABPA
Drugs (esp NSAIDS and abx), toxin, radiation

Other lung dz assoc with eosinophilia:
Organizing pna, asthma, interstitial pna, lung transplant, langerhans cell granulomatosis, sarcoid, paraneoplastic eosinophilic pneumonia

Causes
Often there is no cause…
Idiopathic Eosinophilic Pneumonia
Chronic  vs.  Acute
Churg-Strauss syndrome
Hypereosinophilic syndrome
(all other organs can have eosinophilic infiltration too…ie esophagitis, vasculitis, fasciitis)

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