• Vol. 33 No. 4, 521–523
  • 15 July 2004

Pulmonary Hypereosinophilia



Introduction: Eosinophilic lung diseases are a diverse group of pulmonary disorders linked by the common finding of increased eosinophilia in blood and/or tissue. They usually present to the clinician as pulmonary infiltrates with eosinophilia for which the differential diagnoses is fairly broad.

Clinical Picture: Three patients presented with subacute cough, pulmonary infiltrates and a markedly elevated eosinophil count >1.5 x 109/L. Each case exemplifies its clinical peculiarities and pearls and illustrates the diversity in this group of disorders.

Treatment: A common theme in the approach to its management is excluding infection before proceeding with therapy, often with steroids.

Outcome: There is often a dramatic response to steroid therapy with resolution of symptoms and chest radiographic findings.

Conclusion: The arbitrary label of “pulmonary hypereosinophilia” enables the differential diagnoses to be narrowed to the 4 main categories of infections with parasites or fungus, the Churg-Strauss syndrome, chronic eosinophilic pneumonia and the idiopathic hypereosinophilic syndrome.

Eosinophilic lung diseases encompass a heterogenous spectrum of lung disorders defined by increased eosinophils in blood and/or tissue. In 1952, Crofton et al proposed the term “pulmonary eosinophilia” for disorders characterised by chest radiographic infiltrates and peripheral eosinophilia.

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