Acute eosinophilic pneumonia

Introduction

Introduction to acute eosinophilic pneumonia

Acute eosinophilic pneumonia (AEP) was first reported in 1989. Because it is different from simple pulmonary eosinophilic infiltration, it has been regarded as an independent clinical disease in recent years.

basic knowledge

The proportion of sickness: 0.004% - 0.005%

Susceptible people: no special people

Mode of infection: non-infectious

Complications: cough

Pathogen

Acute eosinophilic pneumonia

(1) Causes of the disease

The cause is not clear, and it is believed to be related to allergic substances in the inhaled environment. It is suspected that the hypersensitivity reaction caused by unknown allergens is unknown.

(two) pathogenesis

The main pathological changes were acute diffuse alveolar damage. Eosinophil infiltration was observed in the alveolar space, interstitial and bronchial wall. In most cases, hyaline membrane formation was observed. Type II alveolar epithelial cells proliferated, and interstitial edema and inflammation were observed in the later stage. A large number of cells infiltrated and fibrous tissue hyperplasia, no vasculitis and impaired lung organs.

Prevention

Acute eosinophilic pneumonia prevention

There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.

Complication

Acute eosinophilic pneumonia complications Complications cough

With muscle pain, cough, shortness of breath, chest pain.

Symptom

Acute eosinophilic pneumonia symptoms Common symptoms Chest pain, shortness of breath, hemoptysis, cough and myalgia

Some may have a history of allergies, acute onset, manifested as fever, myalgia, cough, shortness of breath, chest pain.

The diagnosis of acute eosinophilic pneumonia must first exclude pulmonary eosinophilic infiltration caused by other causes.

Examine

Examination of acute eosinophilic pneumonia

Peripheral blood

The total number of white blood cells was significantly increased, while the increase of eosinophils was not obvious, but the eosinophils in BALF were significantly increased, and the classification count was often greater than 25%.

2. The levels of interleukin-5 and vascular endothelial growth factor (VEGF) in BALF are often elevated.

3. Serum total IgE levels were moderately elevated, hypoxemia (PaO2 <60 mmHg), and some patients experienced severe respiratory failure.

4. X-ray inspection

The early chest X-ray showed a lighter, densely spotted infiltrates, with the Kedey B line, which rapidly (within 48 hours) develop a diffusely symmetric alveolar and interstitial infiltration of the lungs, similar to ARDS's ground-glass or micro-junction In the form of nodules, there may be a small to moderate amount of pleural effusion.

5. CT scan showed diffuse pulmonary parenchymal infiltration.

6. Pulmonary function tests showed limited ventilatory impairment with diffuse dysfunction.

7. Pleural effusion has a high pH and contains a large number of eosinophils.

Diagnosis

Diagnosis and identification of acute eosinophilic pneumonia

Acute lung injury/acute respiratory distress syndrome, blood, sputum, feces, BALF and transbronchial lung biopsy specimens must be cultured, Grans and fungal staining and serological tests to exclude bacterial, mycoplasmal, fungal and parasitic infections.