Allergy Asthma Immunol Res.  2013 Jul;5(4):242-244. 10.4168/aair.2013.5.4.242.

Acute Eosinophilic Pneumonia Leading to Acute Respiratory Failure in a Current Systemic Corticosteroid User

Affiliations
  • 1Department of Anesthesiology & Pain Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
  • 2Department of Chest Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
  • 3Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea. jykimmd@cau.ac.kr

Abstract

A 69-year-old female patient visited the emergency room with fever (38.3degrees C) and dyspnea. She had been taking prednisolone (5 mg once per day) and methotrexate (2.5 mg once per week) for rheumatoid arthritis for 2 years. Chest computed tomography (CT) showed bilateral, multifocal ground glass opacity with interlobular septal thickening. Peripheral blood leukocyte count was 6,520/mm3 (neutrophils, 77.4%; eosinophils, 12.1%). During the night, mechanical ventilation was initiated due to the development of severe hypoxemia. Bronchoalveolar lavage fluid showed a high proportion of eosinophils (49%). Her symptoms improved dramatically after commencement of intravenous methylprednisolone therapy. This is the first report of idiopathic acute eosinophilic pneumonia developing in a current user of systemic corticosteroids.

Keyword

Acute eosinophilic pneumonia; respiratory failure; corticosteroid
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