Acute eosinophilic pneumonia
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Acute eosinophilic pneumonia (AEP) is a type of eosinophilic lung disease.
It is diagnosed when follwingthe following combination clinical and radiographic findings occur 5,7:
- febrile illness of less than
5five days’duration - hypoxaemia
- diffuse alveolar or mixed alveolar-interstitial opacities on chest radiography
- broncho-alveovar lavage fluid consisting of
more than 25>25% eosinophils - absence of parasitic, fungal
,or other infection - prompt and complete response to corticosteroids
- no relapse after discontinuation of corticosteroids
Pathology
The exact cause is not well known. Peripheral blood eosinophil counts are usually normal, although they can become elevated during the subsequent clinical course. A very high eosinophil count in broncho-alveovar lavage is characteristic of the condition.
Radiographic features
Imaging features have to be interpredinterpreted in the correct clinical context.
CT - HRCT
Described features include 4,6,8
- bilateral ground-glass areas
-: common -
interlobular septal thickening
- common: common -
air-space consolidation
- present: present in around half of cases - ill defined centrilobular nodules
- present: present in arounda thridone-third of cases. -
thickening of bronchovascular bundles
- present: present in around2/3rdsof. -
pleural effusions
- can: can be present inaround~80% (range 60-100%) of cases
Zonal distribution
- central to peripheral zonal distribution 6
- central
- ~ 10~10% - peripheral
- 30~30% - random
- ~ 60~60%.
- central
- apico-basal overall zonal distribution 6
- upper lobe
- ~ 15~15% - lower lobes
- ~ 30~30% - random
- ~ 65~65%
- upper lobe
-<p><strong>Acute eosinophilic pneumonia (AEP)</strong> is a type of <a title="Eosinophilic lung disease" href="/articles/eosinophilic-lung-disease-1">eosinophilic lung disease</a>. </p><p>It is diagnosed when follwing combination clinical and radiographic findings occur <sup>5,7</sup></p><ul>-<li>febrile illness of less than 5 days’ duration</li>-<li>hypoxaemia</li>-<li>diffuse alveolar or mixed alveolar-interstitial opacities on chest radiography</li>-<li>broncho-alveovar lavage fluid consisting of more than 25% eosinophils</li>-<li>absence of parasitic, fungal, or other infection</li>-<li>prompt and complete response to corticosteroids</li>-<li>no relapse after discontinuation of corticosteroids</li>-</ul><h4>Pathology</h4><p>The exact cause is not well known. Peripheral blood eosinophil counts are usually normal, although they can become elevated during the subsequent clinical course. A very high eosinophil count in broncho-alveovar lavage is characteristic of the condition. </p><h4>Radiographic features</h4><p>Imaging features have to be interpred in the correct clinical context.</p><h5>CT - HRCT</h5><p>Described features include <sup>4,6,8</sup></p><ul>-<li>bilateral <a title="Ground-glass opacity" href="/articles/ground-glass_opacity">ground-glass </a>areas - common </li>-<li>-<a title="Interlobular septal thickening" href="/articles/interlobular-septal-thickening">interlobular septal thickening</a> - common </li>-<li>-<a title="air-space consolidation" href="/articles/air-space-consolidation">air-space consolidation</a> - present in around half of cases </li>-<li>ill defined <a title="centrilobular nodules" href="/articles/centrilobular-lung-nodules-1">centrilobular nodules</a> - present in around a thrid of cases. </li>-<li>-<a title="thickening of bronchovascular bundles" href="/articles/thickening-of-bronchovascular-bundles">thickening of bronchovascular bundles</a> - present in around 2/3<sup>rds</sup> of cases. </li>-<li>-<a title="Pleural effusions" href="/articles/pleural-effusion">pleural effusions</a> - can be present in around 60-100% of cases</li>- +<p><strong>Acute eosinophilic pneumonia (AEP)</strong> is a type of <a href="/articles/eosinophilic-lung-disease-1">eosinophilic lung disease</a>. <span style="line-height:1.6em">It is diagnosed when the following combination clinical and radiographic findings occur </span><sup style="line-height:1.6em">5,7</sup><span style="line-height:1.6em">:</span></p><ul>
- +<li>febrile illness of less than five days duration</li>
- +<li>hypoxaemia</li>
- +<li>diffuse alveolar or mixed alveolar-interstitial opacities on chest radiography</li>
- +<li>broncho-alveovar lavage fluid consisting of >25% eosinophils</li>
- +<li>absence of parasitic, fungal or other infection</li>
- +<li>prompt and complete response to corticosteroids</li>
- +<li>no relapse after discontinuation of corticosteroids</li>
- +</ul><h4>Pathology</h4><p>The exact cause is not well known. Peripheral blood eosinophil counts are usually normal, although they can become elevated during the subsequent clinical course. A very high eosinophil count in broncho-alveovar lavage is characteristic of the condition.</p><h4>Radiographic features</h4><p>Imaging features have to be interpreted in the correct clinical context.</p><h5>CT - HRCT</h5><p>Described features include <sup>4,6,8</sup></p><ul>
- +<li>bilateral <a href="/articles/ground-glass-opacity">ground-glass </a>areas: common </li>
- +<li>
- +<a href="/articles/interlobular-septal-thickening">interlobular septal thickening</a>: common</li>
- +<li>
- +<a href="/articles/air-space-consolidation">air-space consolidation</a>: present in around half of cases</li>
- +<li>ill defined <a href="/articles/centrilobular-lung-nodules-1">centrilobular nodules</a>: present in around one-third of cases</li>
- +<li>
- +<a href="/articles/thickening-of-bronchovascular-bundles">thickening of bronchovascular bundles</a>: present in around two-thirds of cases</li>
- +<li>
- +<a href="/articles/pleural-effusion">pleural effusions</a>: can be present in ~80% (range 60-100%) of cases</li>
-<li>central - ~ 10 %</li>-<li>peripheral - 30%</li>-<li>random - ~ 60 %. </li>- +<li>central ~10%</li>
- +<li>peripheral ~30%</li>
- +<li>random ~60%</li>
-</li>- +</li>
-<li>upper lobe - ~ 15 % </li>-<li>lower lobes - ~ 30% </li>-<li>random - ~ 65% </li>- +<li>upper lobe ~15% </li>
- +<li>lower lobes ~30% </li>
- +<li>random ~65% </li>
-</li>- +</li>
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