Tropical pulmonary eosinophilia
- Amy D Klion, MD
Amy D Klion, MD
- Baltimore, MD
Tropical pulmonary eosinophilia (TPE) is a clinical manifestation of lymphatic filariasis, a parasitic infection caused by filarial nematodes (roundworms) that inhabit the lymphatics and bloodstream. Three species cause human lymphatic filariasis: Wuchereria bancrofti, Brugia malayi, and Brugia timori. Infection is transmitted by mosquito vectors; humans are definitive hosts.
TPE is caused by an immune hyperresponsiveness to microfilariae trapped in the lungs [1-4]. The syndrome has also been termed tropical eosinophilia or tropical filarial pulmonary eosinophilia. Rarely, a similar hyperresponsive pulmonary syndrome can be seen in the setting of intestinal helminth infection .
Issues related to TPE of filarial origin will be reviewed here. Other issues related to lymphatic filariasis are discussed separately. (See "Epidemiology, pathogenesis, and clinical manifestations of lymphatic filariasis" and "Diagnosis, treatment, and prevention of lymphatic filariasis".)
Tropical pulmonary eosinophilia (TPE) can occur in any tropical area where filariasis occurs and is most common among young adults. It is more common in individuals from the Indian subcontinent and occurs four to seven times more frequently in males than in females [6,7].
The majority of cases of TPE occur in endemic areas; cases in nonendemic settings have also been described. In a review of 17 cases observed in Toronto, all received an incorrect diagnosis at presentation (most often asthma), and a median of two consultations was required before the diagnosis was established .
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