Skip to main content
PMC home page
Thorax logoLink to Thorax
. 1980 Aug;35(8):570–580. doi: 10.1136/thx.35.8.570

Chronic eosinophilic pneumonia.

B Fox, W A Seed
PMCID: PMC471337  PMID: 7003796

Abstract

We described three cases of eosinophilic pneumonia of unknown aetiology investigated clinically and by lung biopsy. The illnesses lasted between six and 20 weeks and consisted of cough, dyspnoea, malaise, and in two cases prolonged pyrexia. All had blood eosinophilia and chest radiographs showing widespread bilateral shadowing; in two cases this had a characteristic peripheral distribution. One patient recovered spontaneously and the other two responded to steroids, with disappearance of pyrexia within 12 hours and radiological clearing within 14 days. Lung function tests during the acute illness showed volume restriction or gas transfer defects or both in two cases. After remission all three showed abnormalities if small airways function. Lung biopsies performed during the acute illness were examined histologically and by transmission electron microscopy, and in two cases by immunofluorescence. There was both intra-alveolar and interstitial eosinophilic pneumonia with bronchiolitis obliterans, microgranulomata, and a vasculitis. Electron microscopy showed numerous eosinophils, many degranulated, and macrophages with phagocytosed eosinophilic granules and intracytoplasmic inclusions. In one case IgM, IgG, and IgA were demonstrated in the bronchial walls and interstitium. No IgE or complement was present. We believe that eosinophil granules are responsible for the tissue damage and fever and suggest mechanisms for this and for the response to steroid therapy.

Full text

PDF
572

Images in this article

571Image
on p.571
572Image
on p.572
573Image
on p.573
574Image
on p.574
574Image
on p.574
575Image
on p.575
576Image
on p.576
577Image
on p.577

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ARCHER G. T., HIRSCH J. G. MOTION PICTURE STUDIES ON DEGRANULATION OF HORSE EOSINOPHILS DURING PHAGOCYTOSIS. J Exp Med. 1963 Aug 1;118:287–294. doi: 10.1084/jem.118.2.287. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Angelillo V. A., Kanner R. E., Renzetti A. D., Jr Chronic eosinophilic pneumonia: a report of four cases and a review of the literature. Am J Med Sci. 1977 May-Jun;273(3):279–287. [PubMed] [Google Scholar]
  3. Basset F., Escaig J., Le Crom M. A cytoplasmic membranous complex in histiocytosis X. Cancer. 1972 May;29(5):1380–1386. doi: 10.1002/1097-0142(197205)29:5<1380::aid-cncr2820290540>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  4. Basset F., Soler P., Wyllie L., Mazin F., Turiaf J. Langerhans' cells and lung interstitium. Ann N Y Acad Sci. 1976;278:599–611. doi: 10.1111/j.1749-6632.1976.tb47075.x. [DOI] [PubMed] [Google Scholar]
  5. Bedrossian C. W., Greenberg S. D., Williams L. J., Jr Ultrastructure of the lung in Loeffler's pneumonia. Am J Med. 1975 Mar;58(3):438–443. doi: 10.1016/0002-9343(75)90611-7. [DOI] [PubMed] [Google Scholar]
  6. Black L. F., Offord K., Hyatt R. E. Variability in the maximal expiratory flow volume curve in asymptomatic smokers and in nonsmokers. Am Rev Respir Dis. 1974 Sep;110(3):282–292. doi: 10.1164/arrd.1974.110.3.282. [DOI] [PubMed] [Google Scholar]
  7. Buist A. S., Ross B. B. Predicted values for closing volumes using a modified single breath nitrogen test. Am Rev Respir Dis. 1973 May;107(5):744–752. doi: 10.1164/arrd.1973.107.5.744. [DOI] [PubMed] [Google Scholar]
  8. Buist A. S., Ross B. B. Quantitative analysis of the alveolar plateau in the diagnosis of early airway obstruction. Am Rev Respir Dis. 1973 Nov;108(5):1078–1087. doi: 10.1164/arrd.1973.108.5.1078. [DOI] [PubMed] [Google Scholar]
  9. CHRISTOFORIDIS A. J., MOLNAR W. Eosinophilic pneumonia. Report of two cases with pulmonary biopsy. J Am Med Assoc. 1960 May 14;173:157–161. doi: 10.1001/jama.1960.03020200029008. [DOI] [PubMed] [Google Scholar]
  10. CROFTON J. W., LIVINGSTONE J. L., OSWALD N. C., ROBERTS A. T. M. Pulmonary eosinophilia. Thorax. 1952 Mar;7(1):1–35. doi: 10.1136/thx.7.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Carrington C. B., Addington W. W., Goff A. M., Madoff I. M., Marks A., Schwaber J. R., Gaensler E. A. Chronic eosinophilic pneumonia. N Engl J Med. 1969 Apr 10;280(15):787–798. doi: 10.1056/NEJM196904102801501. [DOI] [PubMed] [Google Scholar]
  12. Citro L. A., Gordon M. E., Miller W. T. Eosinophilic lung disease (or how to slice P.I.E.). Am J Roentgenol Radium Ther Nucl Med. 1973 Apr;117(4):787–797. doi: 10.2214/ajr.117.4.787. [DOI] [PubMed] [Google Scholar]
  13. Ford R. M. Transient pulmonary eosinophilia and asthma. A review of 20 cases occurring in 5,702 asthma sufferers. Am Rev Respir Dis. 1966 May;93(5):797–803. doi: 10.1164/arrd.1966.93.5.797. [DOI] [PubMed] [Google Scholar]
  14. Gaensler E. A., Carrington C. B. Peripheral opacities in chronic eosinophilic pneumonia: the photographic negative of pulmonary edema. AJR Am J Roentgenol. 1977 Jan;128(1):1–13. doi: 10.2214/ajr.128.1.1. [DOI] [PubMed] [Google Scholar]
  15. Hashimoto K. Lanthanum staining of Langerhans' cell. Communication of Langerhans' cell granules with extracellular space. Arch Dermatol. 1970 Sep;102(3):280–290. [PubMed] [Google Scholar]
  16. Hubscher T. Role of the eosinophil in the allergic reactions. II. Release of prostaglandins from human eosinophilic leukocytes. J Immunol. 1975 Apr;114(4):1389–1393. [PubMed] [Google Scholar]
  17. Katzenstein A. L., Liebow A. A., Friedman P. J. Bronchocentric granulomatosis, mucoid impaction, and hypersensitivity reactions to fungi. Am Rev Respir Dis. 1975 Apr;111(4):497–537. doi: 10.1164/arrd.1975.111.4.497. [DOI] [PubMed] [Google Scholar]
  18. Liebow A. A., Carrington C. B. The eosinophilic pneumonias. Medicine (Baltimore) 1969 Jul;48(4):251–285. doi: 10.1097/00005792-196907000-00001. [DOI] [PubMed] [Google Scholar]
  19. Malkiewicz B., Pajdak W., Okulski J., Lisiewicz J. Recherches sur l'activité thromboplastique des 'eosinophiles d'un malade atteint de leucémie éosinophilique. Haematologia (Budap) 1971;5(4):439–446. [PubMed] [Google Scholar]
  20. Mickenberg I. D., Root R. K., Wolff S. M. Bactericidal and metabolic properties of human eosinophils. Blood. 1972 Jan;39(1):67–80. [PubMed] [Google Scholar]
  21. Morrissey W. L., Gaensler E. A., Carrington C. B., Turner H. G. Chronic eosinophilic pneumonia. Respiration. 1975;32(6):453–468. doi: 10.1159/000193678. [DOI] [PubMed] [Google Scholar]
  22. Parmley R. T., Spicer S. S. Altered tissue eosinophils in Hodgkin's Disease. Exp Mol Pathol. 1975 Aug;23(1):70–82. doi: 10.1016/0014-4800(75)90007-6. [DOI] [PubMed] [Google Scholar]
  23. Perrault J. L., Janis M., Wolinsky H. Resolution of chronic eosinophilic pneumonia with corticoid therapy. Demonstration by needle biopsy. Ann Intern Med. 1971 Jun;74(6):951–954. doi: 10.7326/0003-4819-74-6-951. [DOI] [PubMed] [Google Scholar]
  24. Rao M., Steiner P., Rose J. S., Kassner E. G., Kottmeier P., Steiner M. Chronic eosinophilic pneumonia in a one-year-old child. Chest. 1975 Jul;68(1):118–120. doi: 10.1378/chest.68.1.118. [DOI] [PubMed] [Google Scholar]
  25. Robertson C. L., Shackelford G. D., Armstrong J. D. Chronic eosinophilic pneumonia. Radiology. 1971 Oct;101(1):57–61. doi: 10.1148/101.1.57. [DOI] [PubMed] [Google Scholar]
  26. Scadding J. G. Eosinophilic infiltrations of the lungs in asthmatics. Proc R Soc Med. 1971 Apr;64(4):381–392. [PMC free article] [PubMed] [Google Scholar]
  27. Spry C. J., Tai P. C. Studies on blood eosinophils. II. Patients with Löffler's cardiomyopathy. Clin Exp Immunol. 1976 Jun;24(3):423–434. [PMC free article] [PubMed] [Google Scholar]
  28. Zucker-Franklin D. Electron microscopic studies of human granulocytes: structural variations related to function. Semin Hematol. 1968 Apr;5(2):109–133. [PubMed] [Google Scholar]
  29. el-Hashimi W. Charcot-Leyden crystals. Formation from primate and lack of formation from nonprimate eosinophils. Am J Pathol. 1971 Nov;65(2):311–324. [PMC free article] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES