Chronic eosinophilic pneumonia
- Kevin K Brown, MD
Kevin K Brown, MD
- Professor of Medicine
- National Jewish Health, University of Colorado
- Talmadge E King, Jr, MD
Talmadge E King, Jr, MD
- Editor-in-Chief — Pulmonary and Critical Care Medicine
- Section Editor — Interstitial Lung Disease
- Dean, School of Medicine
- Vice Chancellor, Medical Affairs
- University of California San Francisco
Chronic eosinophilic pneumonia (CEP) is an idiopathic disorder characterized by an abnormal and marked accumulation of eosinophils in the interstitium and alveolar spaces of the lung [1,2].
The clinical manifestations, diagnosis, and treatment of chronic eosinophilic pneumonia will be reviewed here. The evaluation and differential diagnosis of eosinophilic lung diseases, in general, and an approach to acute eosinophilic pneumonia are presented separately. (See "Causes of pulmonary eosinophilia" and "Idiopathic acute eosinophilic pneumonia".)
CEP is a rare disorder. The incidence of CEP in an Icelandic registry was 0.23 cases/100,000 population per year between 1990 and 2004 . In registries of interstitial lung disease (ILD) in Europe, CEP accounted for 0 to 2.5 percent of cases of ILD . Women develop CEP about twice as often as men. A majority of patients are nonsmokers.
CEP typically affects patients in their 30s or 40s, although onset in childhood has been reported [5-7]. A history of atopy is found in 60 percent. Asthma precedes, accompanies, or subsequently occurs in over 50 percent of cases .
The disease has a gradual onset, with an interval of approximately four to five months between the appearance of initial symptoms and diagnosis . Typical symptoms include a productive cough (33 to 42 percent), fever (67 percent), breathlessness (57 to 92 percent), weight loss (57 to 75 percent), and night sweats [5,9].To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- CLINICAL MANIFESTATIONS
- Pulmonary function tests
- DIFFERENTIAL DIAGNOSIS
- Initial treatment
- Assessing the response to therapy
- Treatment of disease relapse
- Duration of therapy
- Potential alternative therapies
- Prevention of glucocorticoid-related adverse effects
- SUMMARY AND RECOMMENDATIONS