Eosinophilic lung disorders are a category of lung problems characterized by having an increased number of eosinophils (white blood cells) in the lungs. These white blood cells are part of the immune system and fight off allergic or chemical reactions and certain infections.
Eosinophilic pneumonia describes a category of pneumonias that feature increased numbers of eosinophils in the lung tissue. Pneumonia is an inflammatory condition of the lungs, particularly involving the air sacs. When the lungs are inflamed, they become swollen, which can result in low oxygen in the bloodstream.
Acute Idiopathic Eosinophilic Pneumonia
Acute idiopathic eosinophilic pneumonia is a more sudden and faster progression of this type of pneumonia. It can be dangerous and progress to respiratory failure and require hospitalization. Symptoms include wheezing, chest tightness, cough, chest pain, increased phlegm (mucus), shortness of breath and rapid breathing. It may involve bloody mucus, fever, muscle aches, decreased oxygenation, and even respiratory failure. The cause of acute eosinophilic pneumonia is unknown (idiopathic).
Chronic Eosinophilic Pneumonia
Chronic eosinophilic pneumonia describes eosinophilic pneumonia that occurs typically for more than one month. The symptoms of chronic eosinophilic pneumonia are slower and more low grade than the acute type. People may have a lingering illness and generally feel unwell, and also have a cough, progressive shortness of breath, persistent asthma-like symptoms such as chest tightness and wheezing, or weight loss. Symptoms can be similar to acute eosinophilic pneumonia but do not progress as quickly. Chronic eosinophilic pneumonia can occur in association with blood cancer, autoimmune disease, fungal or parasitic infection. However, in many instances the cause remains unknown (idiopathic).
If eosinophilic pneumonia is suspected, the physician may order imaging tests such as a CT scan of the chest or a chest x-ray. He or she will order blood tests to determine the level of eosinophils circulating in the blood as well as look for other markers of inflammation or underlying disease in the blood. In order to determine if a pneumonia fits in the category of eosinophilic pneumonia, a biopsy (taking a lung tissue sample via needle, tube, or surgery) should be done to confirm that there is an increase in eosinophil number in the lung tissue.
Treatment of acute eosinophilic pneumonia may require hospitalization. It may be necessary to support the person with assistance from a breathing machine. Treatment with intravenous (IV) steroids or other medications which suppress the immune system may help stop or decrease the inflammation and prevent respiratory failure. Finding and treating underlying causes such as malignancy (cancerous cells that can spread throughout the body), autoimmune disease and infection also is important.