Eosinophilic Lung Disease Flashcards
Eosinophil granules contents
Major Basic protein (MBP), Eosinophilic cationic protein, Eosinophil derived neurotoxin, Charcot-Leyden crystal protein
Cytokines that stimulate growth, differentiation, and production of eosinophils
IL-5, IL-3, GM-CSF
Cytokine specific for eosinophils
IL-5
Allergic Bronchopulmonary Mycosis also known as
Allergic Bronchopulmonary Aspergillosis
2 diseases that have high risk of ABPA
Asthmatics and Cystic Fibrosis
Stage I ABPA characteristics
Acute, elevated IgE, Ashtma, Eosinophilia, Opacities, Precipitating antibody
Stage II ABPA characteristics
Remission, symptom resolution, reduced IgE
Stage III ABPA characteristics
Exacerbation, increased IgE and symptom recurrence
Stage IV ABPA characteristics
Steroid dependent asthma, elevated IgE
Stage V ABPA characteristics
Fibrotic lung disease
ABPA radiographic features
Transient opacities, upper lobe predominant, Finger in glove, Mucoid impaction, Proximal/central bronchiectasis
ABPA pathology
Mucoid Impaction, bronchocentric inflammation with eosinophils, lymphocytes, and plasma cells
ABPA treatment
Steroids, itraconazole, standard asthma treatment, limited evidence for omalizumab
Loeffler syndrome definition
Simple pulmonary eosinophilia
Causes of loeffler syndrome
Parasites, drugs, idiopathic
CXR findings with loeffler syndrome
Fleeting opacities
Treatment loeffler syndrome
Self limited, rarely needs steroids
Paragonimiasis definition
Eosinophilic pleural effusion
Tropical pulmonary eosinophilia cause
Wuchereria bancrofti in India, Africa, and SE Asia
Symptoms of Tropical pulmonary eosinophilia
NOCTURNAL COUGH, fevers, weight loss, malaise, dyspnea, wheezing, and chest pain
Treatment of Tropical Pulmonary Eosinophilia
Diethylcarbamazine
Strongyloides cause
Autoinfection in an immunocompromised host
Symptoms of strongyloides
Cough, wheezing, and hemoptysis
Lab and radiologic findings of strongyloides
CXR with ARDS, peripheral eosinophilia
Diagnosis of strongyloides
BAL and TBBx
Treatment of Strongyloides
Thiabendazole or ivermectin
Medications that cause eosinophilia
Daptomycin, ASA, SSRIs
What eosinophilic lung disease DOES NOT have peripheral eosinophilia
Acute eosinophilia pneumonia
Associations with acute eosinophilic pneumonia
Healthy, young people with a recent onset of smoking cessation, BAL eosinophilia >25%
Characteristics of chronic eosinophilic pneumonia
Middle age women non-smokers, Asthma, peripheral eosinophilia > 30%
Radiographs for chronic eosinophilic pneumonia
Photonegative pulmonary edema, non-resolving pneumonia
Idiopathic hypereosinophilic syndrome classic findings
Young middle aged males with eosinophilia > 1500 for > 6 months or 2 exams > 1 month apart
Treatment of idiopathic hypereosinophilic syndrome
Corticosteroids, IFN-alpha, chemotherapy, hydroxyurea, imatinib, mepolizumab
3 phases of churg strauss
Asthmatic (prodromal 8-10 years), eosinophilic (peripheral and tissue eosinophilia), Vasculitis (necrotizing vasculitis and granulomas)
Diagnostic criteria of churg strauss
Asthma, mononeuritis multiplex, sinus disease, peripheral eosinophilia > 1500 or 10%, Migratory pulmonary opacities, and extravascular eosinophils on biopsy; MUST HAVE 4 of the 6
Diagnostic strategy for churg strauss
Leukotriene receptor antagonists to decrease steroid use to allow for eosinophilia
Treatmetn of churg strauss
Steroids, azathioprine, MTX, mepolizumab
Assessment for churg strauss
Five factors score (0-2), age > 65, +cardiac, +renal, +GI, absence of ENT
