title: Cigarette smoking-induced acute eosinophilic pneumonia: a case report including a provocation test.
abstract: The mechanism and cause of acute eosinophilic pneumonia are largely unknown. Many factors including the smoking of cigarettes have been suggested, but none have been proven to directly cause acute eosinophilic pneumonia. The authors report a case of acute eosinophilic pneumonia in a young Asian male who recently started smoking. The diagnosis was made based on his clinical course and results of chest radiography, lung spirometry, bronchoalveolar lavage, and transbronchial lung biopsies. After administration of methylprednisolone, his clinical course rapidly improved. A provocation test was designed to establish a connection between cigarette smoking and the development of acute eosinophilic pneumonia. After the provocation test, the patient showed identical symptoms, increase in sputum eosinophils, and worsening of pulmonary function. The results of the provocation test suggest that smoking may directly cause acute eosinophilic pneumonia, and support previous reports of cigarette smoking-induced acute eosinophilic pneumonia.
authors.affiliation: Division of Respiratory and Allergy Medicine, Department of Internal Medicine, Soonchunhyang University School of Medicine, Seoul, Korea.
authors.forename: Gene Hyun
authors.initials: GH
authors.lastname: Bok
authors.forename: Yang-Ki
authors.initials: YK
authors.lastname: Kim
authors.forename: Young Mok
authors.initials: YM
authors.lastname: Lee
authors.forename: Ki-Up
authors.initials: KU
authors.lastname: Kim
authors.forename: Soo-taek
authors.initials: ST
authors.lastname: Uh
authors.forename: Jung Hwa
authors.initials: JH
authors.lastname: Hwang
authors.forename: Dong Won
authors.initials: DW
authors.lastname: Kim
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001985:Bronchial Provocation Tests; D006801:Humans; D008297:Male; D011657:Pulmonary Eosinophilia / Q000209:etiology* / Q000503:physiopathology; D012907:Smoking / Q000009:adverse effects*