[Chronic eosinophilic pneumonia].
METHODS
A 43-year-old woman (patient 1) and a 58-year-old man (patient 2) presented with fever, nocturnal perspiration, dry cough, dyspnoea and general weakness. These symptoms had been present for several months. Repeated courses of antibiotic treatment as outpatients had failed. On admission their general condition was unremarkable.


METHODS
The differential blood count revealed marked eosinophilia of 35% and 27%, respectively, and raised infection parameters. Results of laboratory tests were unremarkable. Conventional radiological films and CT of the thorax showed infiltrates, especially in the periphery. In both patients bronchoscopy revealed moderately severe bronchitis. Broncho-alveolar lavage and the peripheral blood count showed marked eosinophilia of 61% and 54%, respectively. Biopsies did not reveal necrosis, fungal infection, parasites, granulomas or vasculitis.


METHODS
The described findings indicated a chronic eosinophilic pneumonia (CEP) in both patients. Treatment was initiated with high steroid dosage, namely 60 mg prednisolone equivalent daily, gradually reducing with improvement. The symptoms rapidly lessened and the radiological changes regressed after ca. 14 days. Intermittent recurrences were noted in both patients on reduction or termination, respectively, of the steroid treatment which had lasted for several months.


CONCLUSIONS
CEP is an important disease to be considered in the differential diagnosis of unclear pulmonary infiltrates associated with an increased eosinophilia in both peripheral blood and the lungs. In some cases it may be necessary to continue steroid treatment over long periods, even years, to bring the pulmonary changes of CEP under control.
Voss
M
M
Pneumologische Abteilung I, Lungenklinik Heckeshorn, Berlin.
Allewelt
M
M
Lode
H
H
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001706:Biopsy; D002908:Chronic Disease; D003371:Cough / Q000209:etiology; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000209:etiology; D005260:Female; D005334:Fever / Q000209:etiology; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007958:Leukocyte Count; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010998:Pleurisy / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use*; D011379:Prognosis; D011657:Pulmonary Eosinophilia / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D011239:Prednisolone
Die chronische eosinophile Pneumonie (CEP).