title: A case of eosinophilic pneumonia successfully treated with suplatast tosilate alone.
abstract: We report a case of eosinophilic pneumonia that was successfully treated with suplatast tosilate. A 72-year-old woman with hypertension and diabetes, who did not smoke and did not have pets, consulted a physician with the chief complaints of cough, sputum, and slight fever. Chest X-ray films revealed a permeation shadow in the bilateral upper lobes. She visited a hospital because her symptoms did not improve. Pulmonary tuberculosis was suspected because of an elevated inflammatory reaction, and anti-tuberculosis treatment was started. Afterwards, eosinophilia appeared in the peripheral blood. Although daily drugs (nicardipine hydrochloride, pentoxifylline, and ticlopidine hydrochloride) were stopped, eosinophilia did not improve and was detected in a sputum sample. She was diagnosed with pulmonary infiltration with eosinophilia syndrome and hospitalized. Physical examination revealed neither rhonchus nor cardiac murmurs on auscultation. Laboratory findings showed a leukocyte count of 21,300/microl, with eosinophils accounting for 66.3% of cells. A diagnosis of eosinophilic pneumonia was made after a lung biopsy specimen was examined under a bronchial fiberscope. After suspension of anti-tuberculosis drugs and administration of suplatast tosilate 300 mg/day for 4 weeks, symptoms subsided, eosinophilia improved to within normal ranges, eosinophils in sputum disappeared, and the permeation shadow disappeared on chest X-ray films.
authors.affiliation: Departments of Pulmonary and Clinical Immunology, Dokkyo University School of Medicine, Mibu, Tochigi, Japan. drnaotow@jiu.ac.jp
authors.forename: Naoto
authors.initials: N
authors.lastname: Watanabe
authors.forename: Akira
authors.initials: A
authors.lastname: Hirata
authors.forename: Sohei
authors.initials: S
authors.lastname: Makino
authors.forename: Takeshi
authors.initials: T
authors.lastname: Fukuda
mesh_terms: D000368:Aged; D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D001190:Arylsulfonates / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D011657:Pulmonary Eosinophilia / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011859:Radiography; D013452:Sulfonium Compounds / Q000627:therapeutic use*; D016896:Treatment Outcome; D014962:X-Ray Film
chemical_list: D018926:Anti-Allergic Agents; D001190:Arylsulfonates; D013452:Sulfonium Compounds; C073028:suplatast tosilate