SHI Xu , HUANG Xiafei , XIE Jiaxing , ZHANG Qingling , XIAN Mo , YANG Zhaowei , GU Yingying , GUAN Yubao , LI Jing
  • Department of Allergy and Clinical Immunology, Guangzhou Institute of Respiratory Disease, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, China;
LI Jing, Email: jingli1016@vip.163.com
Pulmonary infiltration with eosinophilia; Allergic broncho pulmonary aspergillosis; Eosinophilic granulomatosis with polyangiitis
10.7507/1671-6205.201606021
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Objective  To improve the diagnosis and treatment of pulmonary infiltration with eosinophilia (PIE). Methods  Patients who were diagnosed with PIE in the First Affiliated Hospital of Guangzhou Medical University from January 2004 to December 2013 were recruited and retrospectively analyzed. Data of etiology, clinical manifestation, imaging and pathological features were recorded. Results  pulmonary eosinophilic granuloma (PEG) (n=2), eosinophilic granulomatosis with polyangiitis (EGPA) (n=7), Löffler syndrome (n=4), allergic bronchopulmonary aspergillosis (ABPA) (n=16), and chronic eosinophilic pneumonia (CEP) (n=19). There were 27 males and 21 females. 47.9% of the PIE patients were diagnosed as asthma and treated with regular treatment but had not been controlled well. PEG was characterized with wheeze and anhelation in clinical manifestations, unelevated blood eosinophil counts and percentage, significant small airway abnormalities in lung function, diffuse pneumonectasis in Chest CT, and appearance of eosinophil cells in alveole. EGPA shows dyspnea and cough in clinical manifestations, as well as other organs function damaged, unelevated blood eosinophil counts and percentage, significant FEV1/FVC and small airway abnormalities in lung function, tree-in-bud in Chest CT, appearance of eosinophilic granuloma outside blood vessels. Löffler syndrome also showed cough, shorter course of disease, normal lung function and diffusion. ABPA showed wheeze and cough, 31.3% of them with hemoptysis, normal blood eosinophil count, central bronchiectasis in Chest CT. CEP also showed dyspnea and cough. 21.1% of CEP patientshad chest pain, increasing sputum eosinophil percentage compare with blood eosinophil percentage, and small airway abnormalities in lung function. Conclusions  Most of PIE patients are diagnosed as asthma but haven’t gotten well controlled under the regular anti-asthmatic treatment. Patients with PIE have increasing eosinophil counts and decreasing lung function. The diagnosis of PIE still depends on clinical manifestation, laboratory test, imaging and pathological examination.

Citation： SHI Xu, HUANG Xiafei, XIE Jiaxing, ZHANG Qingling, XIAN Mo, YANG Zhaowei, GU Yingying, GUAN Yubao, LI Jing. Pulmonary infiltration with eosinophilia: a clinical analysis of forty-eight cases. Chinese Journal of Respiratory and Critical Care Medicine, 2017, 16(2): 147-154. doi: 10.7507/1671-6205.201606021 Copy

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