Chronic Eosinophilic Pneumonia As Presented by Brett W

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Chronic Eosinophilic Pneumonia

• As Presented by Brett W. Baskovich

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What is it?

• Pneumonia
• Eosinophilic
• Chronic

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Causes of Eosinophilic Pneumonia

• Churg-Strauss Syndrome
• Allergic Bronchopulmonary Aspergillosis
• Medications/Drugs/Toxins
• Nitrofurantoin, ampicillin, ibuprofen, naproxen,
  phenytoin, sulfasalazine, tetracycline
• Parasites- Löffler's syndrome

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Symptoms

• Cough
• Fever
• Shortness of breath
• Night sweats
• Wheezing
• Weight loss

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Diagnosis

• Typically made 7 mo. after sx begin
• Bronchoalveolar lavage

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Treatment

• Option 1 Steroids

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Treatment

• Prednisone 40 60 mg/day
• Continue until Sx and CXR resolved (4-6 weeks)
• Cut dose in half (8 weeks)
• Reduce by 5 mg every 4 weeks

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Treatment

• Maintain patient on minimum possible dose
• Switch to alternate-day prednisone
• Add inhaled corticosteroids

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Treatment

• High-dose inhaled corticosteroid
• Beclometasone dipropionate 1,600 mcg/day

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References

• Chronic eosinophilic pneumonia complicated by
  bronchial asthma and diabetes mellitus
  successfully treated with suplatast tosilate and
  high-dose inhaled corticosteroid therapy.
  Fujimori K, Shimatsu Y et al. Nihon Kokyuki
  Gakkai Zasshi. 1999 Nov37(11)903-8.
• Chronic eosinophilic pneumonia treatment with
  inhaled corticosteroids. Minakuchi M, Niimi A et
  al. Respiration. 2003 Jul-Aug70(4)362-6.
• Eosinophilic lung diseases a clinical,
  radiologic, and pathologic overview. Jeong YJ,
  Kim KI et al. Radiographics. 2007
  May-Jun27(3)617-37 discussion 637-9.
• Chronic eosinophilic pneumonia. Edwards LT,
  Fulmer JM et al. BUMC Proceedings. 19991267-74.
• Chronic eosinophilic pneumonia a review. Alam M,
  Burki NK. South Med J. 2007 Jan100(1)49-53.