title: Eosinophilic pneumonias in children: A review of the epidemiology, diagnosis, and treatment.
abstract: Pediatric eosinophilic pneumonias (EPs) are characterized by a significant infiltration of the alveolar spaces and lung interstitium by eosinophils, with conservation of the lung structure. In developed countries, EPs constitute exceptional entities in pediatric care. Clinical symptoms may be transient (Löffler syndrome), acute (<1 month and mostly <7 days), or chronic (>1 month). Diagnosis relies on demonstration of alveolar eosinophilia on bronchoalveolar lavage, whether or not associated with blood eosinophilia. EPs are a heterogeneous group of disorders divided into: (i) secondary forms (seen mainly in parasitic infections, allergic bronchopulmonary aspergillosis, and drug reactions); and (ii) primary forms (eosinophilic granulomatosis with polyangiitis, hypereosinophilic syndrome, idiopathic chronic eosinophilic pneumonia, and idiopathic acute eosinophilic pneumonia). Despite their rarity, the etiological approach to EP must be well-defined as some causes can be rapidly life-threatening without initiation of the proper treatment. This approach (i) eliminates secondary forms, with comprehensive history taking and minimal biological assessment, (ii) is oriented in primary forms by the acute or chronic setting, and the existence of extrapulmonary symptoms. Treatment of primary forms has traditionally relied on corticosteroids, usually with a dramatic response. Specific treatments or the adjunction of corticosteroid-sparing treatment or immunosuppressors are currently being evaluated in order to improve the prognosis and the side effects associated with corticosteroid treatment in a pediatric setting.
authors.affiliation: Department of Pediatric Pulmonology and Allergology, Hôpitaux pédiatriques de Nice CHU-Lenval, Nice, France.|Université de Nice Sophia Antipolis, Nice, France.
authors.forename: Lisa
authors.initials: L
authors.lastname: Giovannini-Chami
authors.affiliation: Department of Pediatric Pulmonology and Allergology, Hôpitaux pédiatriques de Nice CHU-Lenval, Nice, France.
authors.forename: Sibylle
authors.initials: S
authors.lastname: Blanc
authors.affiliation: Department of Pediatric Pulmonology, AP-HP, Hôpital Necker Enfants Malades, Paris, France.|Université Paris Descartes-Paris 5, Paris, France.
authors.forename: Alice
authors.initials: A
authors.lastname: Hadchouel
authors.affiliation: Department of Pediatric Hematology, AP-HP, Hôpital Robert Debré, Paris, France.|Université Paris Diderot VII, Paris, France.
authors.forename: André
authors.initials: A
authors.lastname: Baruchel
authors.affiliation: Department of Pediatric Pulmonology, Centre Hospitalier Universitaire Mustapha, Alger, Algérie.
authors.forename: Rachida
authors.initials: R
authors.lastname: Boukari
authors.affiliation: Department of Pediatric Pulmonology, Centre Hospitalier Universitaire de Marseille, Marseille, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Dubus
authors.affiliation: Department of Pediatric Pulmonology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.|Département de Pédiatrie, Centre d'Investigation Clinique, Bordeaux, France.
authors.forename: Michael
authors.initials: M
authors.lastname: Fayon
authors.affiliation: Department of Pediatric Pulmonology, AP-HP, Hôpital Necker Enfants Malades, Paris, France.
authors.forename: Muriel
authors.initials: M
authors.lastname: Le Bourgeois
authors.affiliation: Department of Pediatric Pulmonology, AP-HP, Hôpital Trousseau, Paris, France.|Université Pierre et Marie Curie-Paris 6, Paris, France.
authors.forename: Nadia
authors.initials: N
authors.lastname: Nathan
authors.affiliation: Department of Pediatric Pulmonology and Allergology, Hôpitaux pédiatriques de Nice CHU-Lenval, Nice, France.|Université de Nice Sophia Antipolis, Nice, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Albertini
authors.affiliation: Department of Pediatric Pulmonology, AP-HP, Hôpital Trousseau, Paris, France.|Université Pierre et Marie Curie-Paris 6, Paris, France.
authors.forename: Annick
authors.initials: A
authors.lastname: Clément
authors.affiliation: Department of Pediatric Pulmonology, AP-HP, Hôpital Necker Enfants Malades, Paris, France.|Université Paris Descartes-Paris 5, Paris, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: de Blic
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D018893:Bronchoalveolar Lavage; D002648:Child; D002675:Child, Preschool; D015267:Churg-Strauss Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D017681:Hypereosinophilic Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007958:Leukocyte Count; D008174:Lung Diseases, Parasitic / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D011379:Prognosis; D011657:Pulmonary Eosinophilia / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology*
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents
keywords: allergic bronchopulmonary aspergillosis; drug-induced eosinophilic pneumonia; eosinophilic granulomatosis with polyangiitis; hypereosinophilic asthma; hypereosinophilic syndrome; idiopathic acute eosinophilic pneumonia; idiopathic chronic eosinophilic pneumonia; interstitial lung diseases; tropical eosinophilic pneumonia; visceral larva migrans syndrome