Acute Eosinophilic Pneumonia: Correlation of Clinical Characteristics With Underlying Cause

Federica De Giacomi, Paul A. Decker, Robert Vassallo, Jay H Ryu

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background Acute eosinophilic pneumonia (AEP) is an uncommon disease, often indistinguishable from ARDS or community-acquired pneumonia at initial presentation. AEP can be idiopathic, but identifiable causes include medications and inhalational exposures, including cigarette smoke. Methods Using a computer-assisted search, we retrospectively identified and reviewed the medical records of all patients diagnosed with AEP between January 1, 1998, and June 30, 2016, at our institution. Demographic and clinical data were extracted, including exposures (occupational, environmental, recreational, pharmacologic, and smoking), laboratory and radiologic findings, treatments, hospitalization (including ICU stay), and subsequent clinical course. Results Among 36 consecutive patients with AEP, 11 were smoking-related cases, six were medication-related cases and 19 were idiopathic. Smoking-related AEP included six first-time smokers and five ex-smokers who had resumed smoking after a period of abstinence. Patients with smoking-related AEP were younger compared with both medication-related and idiopathic AEP cases (median age: 22 vs 47.5 vs 55 years, respectively; P =.004). Patients with smoking-related AEP were less likely to be associated with peripheral eosinophilia at presentation (36% vs 50% vs 58%; P =.52) but more likely to be hospitalized (100% vs 50% vs 63%; P =.039), including a longer ICU stay, compared with medication-related and idiopathic cases. Conclusions AEP is associated with a good prognosis when recognized and treated promptly. Compared with medication-related and idiopathic AEP, smoking-related AEP was less likely to be associated with peripheral eosinophilia at presentation but was characterized by more severe disease manifestations.

Original languageEnglish (US)
Pages (from-to)379-385
Number of pages7
JournalChest
Volume152
Issue number2
DOIs
StatePublished - Aug 1 2017

Fingerprint

Pulmonary Eosinophilia
Smoking
Eosinophilia
Environmental Exposure
Occupational Exposure
Smoke
Tobacco Products
Medical Records
Pneumonia
Hospitalization

Keywords

  • acute eosinophilic pneumonia
  • eosinophilia
  • mechanical ventilation
  • tobacco smoke

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Acute Eosinophilic Pneumonia : Correlation of Clinical Characteristics With Underlying Cause. / De Giacomi, Federica; Decker, Paul A.; Vassallo, Robert; Ryu, Jay H.

In: Chest, Vol. 152, No. 2, 01.08.2017, p. 379-385.

Research output: Contribution to journalArticle

De Giacomi, Federica ; Decker, Paul A. ; Vassallo, Robert ; Ryu, Jay H. / Acute Eosinophilic Pneumonia : Correlation of Clinical Characteristics With Underlying Cause. In: Chest. 2017 ; Vol. 152, No. 2. pp. 379-385.
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abstract = "Background Acute eosinophilic pneumonia (AEP) is an uncommon disease, often indistinguishable from ARDS or community-acquired pneumonia at initial presentation. AEP can be idiopathic, but identifiable causes include medications and inhalational exposures, including cigarette smoke. Methods Using a computer-assisted search, we retrospectively identified and reviewed the medical records of all patients diagnosed with AEP between January 1, 1998, and June 30, 2016, at our institution. Demographic and clinical data were extracted, including exposures (occupational, environmental, recreational, pharmacologic, and smoking), laboratory and radiologic findings, treatments, hospitalization (including ICU stay), and subsequent clinical course. Results Among 36 consecutive patients with AEP, 11 were smoking-related cases, six were medication-related cases and 19 were idiopathic. Smoking-related AEP included six first-time smokers and five ex-smokers who had resumed smoking after a period of abstinence. Patients with smoking-related AEP were younger compared with both medication-related and idiopathic AEP cases (median age: 22 vs 47.5 vs 55 years, respectively; P =.004). Patients with smoking-related AEP were less likely to be associated with peripheral eosinophilia at presentation (36{\%} vs 50{\%} vs 58{\%}; P =.52) but more likely to be hospitalized (100{\%} vs 50{\%} vs 63{\%}; P =.039), including a longer ICU stay, compared with medication-related and idiopathic cases. Conclusions AEP is associated with a good prognosis when recognized and treated promptly. Compared with medication-related and idiopathic AEP, smoking-related AEP was less likely to be associated with peripheral eosinophilia at presentation but was characterized by more severe disease manifestations.",
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N2 - Background Acute eosinophilic pneumonia (AEP) is an uncommon disease, often indistinguishable from ARDS or community-acquired pneumonia at initial presentation. AEP can be idiopathic, but identifiable causes include medications and inhalational exposures, including cigarette smoke. Methods Using a computer-assisted search, we retrospectively identified and reviewed the medical records of all patients diagnosed with AEP between January 1, 1998, and June 30, 2016, at our institution. Demographic and clinical data were extracted, including exposures (occupational, environmental, recreational, pharmacologic, and smoking), laboratory and radiologic findings, treatments, hospitalization (including ICU stay), and subsequent clinical course. Results Among 36 consecutive patients with AEP, 11 were smoking-related cases, six were medication-related cases and 19 were idiopathic. Smoking-related AEP included six first-time smokers and five ex-smokers who had resumed smoking after a period of abstinence. Patients with smoking-related AEP were younger compared with both medication-related and idiopathic AEP cases (median age: 22 vs 47.5 vs 55 years, respectively; P =.004). Patients with smoking-related AEP were less likely to be associated with peripheral eosinophilia at presentation (36% vs 50% vs 58%; P =.52) but more likely to be hospitalized (100% vs 50% vs 63%; P =.039), including a longer ICU stay, compared with medication-related and idiopathic cases. Conclusions AEP is associated with a good prognosis when recognized and treated promptly. Compared with medication-related and idiopathic AEP, smoking-related AEP was less likely to be associated with peripheral eosinophilia at presentation but was characterized by more severe disease manifestations.

AB - Background Acute eosinophilic pneumonia (AEP) is an uncommon disease, often indistinguishable from ARDS or community-acquired pneumonia at initial presentation. AEP can be idiopathic, but identifiable causes include medications and inhalational exposures, including cigarette smoke. Methods Using a computer-assisted search, we retrospectively identified and reviewed the medical records of all patients diagnosed with AEP between January 1, 1998, and June 30, 2016, at our institution. Demographic and clinical data were extracted, including exposures (occupational, environmental, recreational, pharmacologic, and smoking), laboratory and radiologic findings, treatments, hospitalization (including ICU stay), and subsequent clinical course. Results Among 36 consecutive patients with AEP, 11 were smoking-related cases, six were medication-related cases and 19 were idiopathic. Smoking-related AEP included six first-time smokers and five ex-smokers who had resumed smoking after a period of abstinence. Patients with smoking-related AEP were younger compared with both medication-related and idiopathic AEP cases (median age: 22 vs 47.5 vs 55 years, respectively; P =.004). Patients with smoking-related AEP were less likely to be associated with peripheral eosinophilia at presentation (36% vs 50% vs 58%; P =.52) but more likely to be hospitalized (100% vs 50% vs 63%; P =.039), including a longer ICU stay, compared with medication-related and idiopathic cases. Conclusions AEP is associated with a good prognosis when recognized and treated promptly. Compared with medication-related and idiopathic AEP, smoking-related AEP was less likely to be associated with peripheral eosinophilia at presentation but was characterized by more severe disease manifestations.

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