SELECTED ARTICLES FROM THE RECENT LITERATURE 2007

September 20, 2007

Chronic eosinophilic pneumonia

Summary
Background - Chronic eosinophilic pneumonia (CEP) is an unusual disorder of unknown etiology.

Findings - CEP was reviewed by Alam and Burki of the Univ of Connecticut. The hallmark of CEP appears to be increased tissue levels of the eosinophil (Eos) chemoattractants eotoxin and RANTES as well as the cytokine IL-5 a major promoter of Eos production and survival. CEP generally presents with a chronic cough and sometimes systemic symptoms. Atopy is common but asthma is not a prerequisite. Infiltrates usually in the periphery of the lung, sometimes migratory are seen in x-rays. Airway obstruction occurs as a late complication at times.

CEP is generally responsive to corticosteroid therapy but relapses are common when the prednisone dose is decreased below about 15 mg/day for an average sized adult.

Reference
South Med J 2007;100:49-53

Editor's Comments
An interesting aspect of CEP is that asthma is unusual in this disorder unlike the situation in allergic bronchopulmonary aspergillosis or the Churg-Strauss Syndrome, two other disorders with eosinophil-rich migratory pulmonary infiltrates. In view of increased IL-5 activity in CEP, a trial of treatment with anti-IL5 monoclonal antibody (now available) may be worthwhile.

 

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