Outcomes of rapid corticosteroid tapering in acute eosinophilic pneumonia patients with initial eosinophilia.
OBJECTIVE
Studies have shown that patients with acute eosinophilic pneumonia (AEP) and with initial eosinophilia have a milder disease than those with an initial normal peripheral eosinophil count (PEC). We investigated the effect of a rapid corticosteroid tapering strategy in AEP patients with initial eosinophilia.


METHODS
We performed a prospective cohort study in patients with AEP with initial eosinophilia (n = 14) who stopped corticosteroid treatment after achieving clinical stabilization compared with AEP patients with an initial normal PEC (n = 45) who received 2-week treatment with corticosteroid.


RESULTS
In total, 59 AEP patients were identified. The median duration of corticosteroid treatment was 4 days (interquartile ranges (IQR), 3-4) in patients with initial eosinophilia and 14 (IQR, 14-14) days in patients with initial normal PEC. No treatment failure occurred in the group with initial eosinophilia; one treatment failure case occurred in the group with an initially normal PEC. The median time to overall clinical stabilization was 3 days, and time to complete resolution of all symptoms and clinical instabilities from diagnosis was 4 days in AEP patients with initial eosinophilia. Both were significantly shorter than those) in the initially normal PEC group, which were 5 and 7 days respectively (both P < 0.001). Adverse effects were lower in AEP patients with initial eosinophilia, and additional medications to relieve adverse effects were only needed in AEP patients with initially normal PEC.


CONCLUSIONS
Rapid corticosteroid tapering may be an acceptable treatment strategy for managing AEP patients with initial eosinophilia.
Division of Pulmonary and Critical Care Medicine, Department of Medicine, The Armed Forces Capital Hospital, Seong-nam, South Korea.
Byung Woo
BW
Jhun
Division of Pulmonary and Critical Care Medicine, Department of Medicine, The Armed Forces Capital Hospital, Seong-nam, South Korea.
Se Jin
SJ
Kim
Division of Pulmonary and Critical Care Medicine, Department of Medicine, The Armed Forces Capital Hospital, Seong-nam, South Korea.
Kang
K
Kim
Division of Pulmonary and Critical Care Medicine, Department of Medicine, The Armed Forces Capital Hospital, Seong-nam, South Korea.
Ji Eun
JE
Lee
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000627:therapeutic use; D004802:Eosinophilia / Q000097:blood / Q000150:complications / Q000188:drug therapy; D004804:Eosinophils; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D011446:Prospective Studies; D011657:Pulmonary Eosinophilia / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D013997:Time Factors; D017211:Treatment Failure; D055815:Young Adult
D000305:Adrenal Cortex Hormones
corticosteroid; eosinophilia; peripheral; pneumonia