[Idiopathic chronic eosinophilic pneumonia - a diagnostic challenge].
METHODS
A 43-year-old woman with clinical signs of a febrile respiratory infection with cough and dyspnea despite several antecedent antibiotic treatments was admitted to hospital because of persistent bilateral pulmonary infiltrates.


METHODS
In the diagnostic work-up, the most striking laboratory abnormality was an eosinophilia of 31% within the differential blood count. Specimen obtained from bronchoalveolar lavage showed an abnormally high level of eosinophils as well. In the absence of other known causes of an eosinophilic pulmonary disease the diagnosis of idiopathic chronic eosinophilic pneumonia was made. After initiation of corticosteroid medication the abnormal laboratory results, the clinical signs, and the radiologic findings almost completely normalized within 1 week.


CONCLUSIONS
If an apparent pneumonia fails to respond to conventional antibiotic treatment, a blood eosinophil count should be obtained. If blood eosinophils are abnormally high, diagnosis of idiopathic acute or chronic eosinophilic pneumonia should be considered and confirmed by demonstrating an excess of eosinophils in bronchoalveolar lavage fluid. Due to prognostic and therapeutic consequences idiopathic acute and chronic eosinophilic pneumonia should be distinguished from one another. A rapid response to glucocorticoid therapy supports the diagnosis. In order to avoid relapses, patients with chronic eosinophilic pneumonia have to complete a 6-month treatment.
Altiok
Ertunc
E
Klinik für Innere Medizin, Medizinisches Zentrum Kreis Aachen gGmbH, Betriebsteil Marienhöhe, Würselen, Akademisches Lehrkrankenhaus Universitätsklinikum Aachen, Würselen. ealtiok@ukaachen.de
Kemper
Rolf
R
Kindler
Joachim
J
D000284:Administration, Oral; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001999:Bronchoscopy; D002908:Chronic Disease; D003937:Diagnosis, Differential; D004334:Drug Administration Schedule; D004802:Eosinophilia / Q000175:diagnosis; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D011239:Prednisolone / Q000627:therapeutic use; D011657:Pulmonary Eosinophilia / Q000175:diagnosis* / Q000188:drug therapy; D012129:Respiratory Function Tests; D014057:Tomography, X-Ray Computed
D000893:Anti-Inflammatory Agents; D011239:Prednisolone