A case of acute eosinophilic pneumonia with clinical features overlapping with chronic eosinophilic pneumonia

만성 호산구성 폐렴의 임상양상을 동반한 급성 호산구성 폐렴 1예

  • Wi, Jeong-Ook (Department of Allergy, Asthma and Clinical Immunology, Chonnam National University Medical School) ;
  • Kim, Sung-Soo (Department of Allergy, Asthma and Clinical Immunology, Chonnam National University Medical School) ;
  • Han, Eui-Ryoung (Department of Allergy, Asthma and Clinical Immunology, Chonnam National University Medical School) ;
  • Koh, Young-Il (Department of Allergy, Asthma and Clinical Immunology, Chonnam National University Medical School)
  • 위정욱 (전남대학교 의과대학 알레르기내과학교실) ;
  • 김성수 (전남대학교 의과대학 알레르기내과학교실) ;
  • 한의령 (전남대학교 의과대학 알레르기내과학교실) ;
  • 고영일 (전남대학교 의과대학 알레르기내과학교실)
  • Received : 2009.09.15
  • Accepted : 2010.02.25
  • Published : 2010.12.01

Abstract

Acute eosinophilic pneumonia (AEP) represents a clinical entity distinct from chronic eosinophilic pneumonia (CEP). In contrast with CEP, AEP is characterized by duration of symptoms less than 5 days, hypoxemic respiratory failure, no blood eosinophilia at presentation, no atopic background or history of asthma, and no recurrence. However, we report a case of AEP with some features of CEP. A 33-year-old man presented with respiratory symptoms for 4 days. He was diagnosed with AEP based on hypoxemic respiratory failure, diffuse alveolar-interstitial chest X-ray infiltrates, and eosinophilia, lymphocytosis and neutrophilia from bronchoalveolar lavages. However, he had two atopic diseases, asthma and atopic dermatitis. In addition, he presented with blood eosinophilia, which are all features of CEP. Thus, there might be some overlap of clinical features between AEP and CEP. The presence of increased lymphocytes and neutrophils in the bronchoalveolar lavage can be an important finding to help distinguish between AEP versus CEP in difficult cases.

본 증례를 통하여 급성 호산구성 폐렴은 아토피질환 존재 등의 만성 호산구성 폐렴의 임상양상을 일부 동반할 수 있으며, 만성 호산구성 폐렴과의 감별이 어려운 경우 기관지폐포세척술을 시행하여 세척액내 호산구뿐만 아니라 림프구 및 호중구의 증가 소견을 증명하면 급성 호산구성 폐렴의 진단에 도움이 될 수 있을 것으로 생각된다.

Keywords

References

  1. Choi DC. Eosinophilic lung diseases: diagnosis and treatment. Korean J Med 76:274-281, 2009
  2. Philit F, Etienne-Mastroianni B, Parrot A, Guerin C, Robert D, Cordier JF. Idiopathic acute eosinophilic pneumonia: a study of 22 patients. Am J Respir Crit Care Med 166:1235-1239, 2002 https://doi.org/10.1164/rccm.2112056
  3. Pope-Harman AL, Davis WB, Allen ED, Christoforidis AJ, Allen JN. Acute eosinophilic pneumonia: a summary of 15 cases and review of the literature. Medicine 75:334-342, 1996 https://doi.org/10.1097/00005792-199611000-00004
  4. Cottin V, Cordier JF. Eosinophilic pneumonias. Allergy 60:841-857, 2005 https://doi.org/10.1111/j.1398-9995.2005.00812.x
  5. Williams HC, Burney PG, Pembroke AC, Hay RJ. The U.K. Working Party's Diagnostic Criteria for Atopic Dermatitis: III. independent hospital validation. Br J Dermatol 131:406-416, 1994 https://doi.org/10.1111/j.1365-2133.1994.tb08532.x
  6. Alam M, Burki NK. Chronic eosinophilic pneumonia: a review. South Med J 100:49-53, 2007 https://doi.org/10.1097/01.smj.0000242863.17778.1d
  7. Marchand E, Cordier JF. Idiopathic chronic eosinophilic pneumonia. Semin Respir Crit Care Med 27:134-141, 2006
  8. Weller PF. Middleton's allergy: principles and practice. 7th ed. p. 871, London, Mosby, 2009
  9. Allen J. Acute eosinophilic pneumonia. Semin Respir Crit Care Med 27:142-147, 2006
  10. llen JN, Davis WB. Eosinophilic lung diseases. Am J Respir Crit Care Med 150:1423-1438, 1994 https://doi.org/10.1164/ajrccm.150.5.7952571
  11. Jederlinic PJ, Sicilian L, Gaensler EA. Chronic eosinophilic pneumonia: a report of 19 cases and a review of the literature. Medicine 67:154-162, 1988 https://doi.org/10.1097/00005792-198805000-00002
  12. Hyun DS, Yeo DS, Kim JW, Lee SH, Lee SY, Kim SC, Seo JY, Song SH, Kim CH, Moon HS, Song JS, Park SH. Acute and chronic eosinophilic pneumonia and clinical and laboratory findings. Tuberc Respir Dis 45:795-804, 1998 https://doi.org/10.4046/trd.1998.45.4.795