Eosinophilic pneumonia diagnostic criteria
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]
Overview
Diagnostic criteria of idiopathic chronic eosinophilic pneumonia include diffuse pulmonary alveolar consolidation, eosinophilia at bronchoalveolar lavage, respiratory symptoms present for at least 2 to 4 weeks, and absence of other known causes of eosinophilic lung disease. Idiopathic acute eosinophilic pneumonia criteria are acute onset with febrile respiratory manifestations, bilateral diffuse infiltrates on imaging, lung eosinophilia, with 25% eosinophils at bronchoalveolar lavage, and absence of determined cause of acute eosinophilic pneumonia.
Diagnosis
A confident diagnosis of Acute eosinophilic pneumonia can usually be made without a lung biopsy in patients who meet the following criteria:[1]
Idiopathic chronic eosinophilic pneumonia[2]
1. Diffuse pulmonary alveolar consolidation with air bronchogram and/or ground-glass opacities at chest imaging with peripheral predominance
2. Eosinophilia at bronchoalveolar lavage differential cell count more than 40%
3. Respiratory symptoms present for at least 2 to 4 weeks
4. Absence of other known causes of eosinophilic lung disease (especially exposure to drug susceptible to induce pulmonary eosinophilia)
Idiopathic acute eosinophilic pneumonia[3]
1. Acute onset with febrile respiratory manifestations, less than a month, and especially 7 days duration before medical examination
2. Bilateral diffuse infiltrates on imaging
3. PaO2 on room air less than 60mmHg, or PaO2/FiO2 less than 300mmHg, or oxygen saturation on room air <90%
4. Lung eosinophilia, with 25% eosinophils at bronchoalveolar lavage differential cell count
5. Absence of determined cause of acute eosinophilic pneumonia (including infection or exposure to drugs known to induce pulmonary eosinophilia). Recent onset of tobacco smoking or exposure to inhaled dusts may be present
References
- ↑ Allen JN, Davis WB (1994). "Eosinophilic lung diseases". Am J Respir Crit Care Med. 150 (5 Pt 1): 1423–38. doi:10.1164/ajrccm.150.5.7952571. PMID 7952571.
- ↑ Swartz J, Stoller JK (2009). "Acute eosinophilic pneumonia complicating Coccidioides immitis pneumonia: a case report and literature review". Respiration. 77 (1): 102–6. doi:10.1159/000109977. PMID 17940333.
- ↑ Philit F, Etienne-Mastroïanni B, Parrot A, Guérin C, Robert D, Cordier JF (2002). "Idiopathic acute eosinophilic pneumonia: a study of 22 patients". Am J Respir Crit Care Med. 166 (9): 1235–9. doi:10.1164/rccm.2112056. PMID 12403693.