From the Research
Eosinophilic pneumonia should be treated with corticosteroids, with prednisone being the first-line therapy at a dose of 40-60 mg daily for 2 weeks, as this duration has been shown to be sufficient for most patients, including those with respiratory failure, according to a study published in 2013 1.
Treatment Overview
The treatment of eosinophilic pneumonia typically involves corticosteroids, which are effective in reducing inflammation and symptoms.
- For severe cases requiring hospitalization, methylprednisolone 60-125 mg IV every 6 hours may be initiated.
- In chronic cases, maintenance therapy with low-dose prednisone (5-10 mg daily) may be necessary.
- For steroid-resistant cases, immunosuppressants like azathioprine (2-3 mg/kg/day) or mycophenolate mofetil (1000-1500 mg twice daily) can be considered.
Diagnosis and Monitoring
Patients should be monitored with regular pulmonary function tests and blood eosinophil counts.
- The condition is thought to result from an allergic or immune response to inhaled antigens, medications, or infections, causing eosinophil recruitment to the lungs and release of inflammatory mediators that damage lung tissue.
- Symptoms typically include cough, shortness of breath, fever, and sometimes wheezing, with diagnosis confirmed through elevated eosinophil counts in blood or bronchoalveolar lavage fluid, along with characteristic chest imaging findings.
Disease Characteristics
Eosinophilic pneumonia is a rare disorder, comprising several heterogeneous diseases, including acute eosinophilic pneumonia (AEP) and chronic eosinophilic pneumonia (CEP), both of which are characterized by marked accumulation of eosinophils in lung tissues and/or BAL fluid, as discussed in a review published in 2019 2.
- AEP and CEP share some similarities in terms of pathophysiology, radiological findings, and treatment response to corticosteroids, but they distinctly differ in etiology, clinical manifestations, and the nature of disease course.
- Although AEP and CEP respond well to corticosteroids, relapse frequently occurs in patients with CEP, but rarely in those with AEP, as noted in a study published in 2019 3.