Korean J Asthma Allergy Clin Immunol.  2007 Dec;27(4):277-282.

Two Cases of Cigarette Smoking-Induced Acute Eosinophilic Pneumonia


Acute eosinophilic pneumonia (AEP) is characterized by idiopathic febrile illness with short duration, severe hypoxemia, diffuse pulmonary infiltration, and eosinophilia in bronchoalveolar lavage fluid. We experienced two cases of AEP following smoking. They started smoking cigarette 3 weeks prior to admission and presented typical clinical and radiological characteristics of AEP. No cause of AEP was identifiable apart from smoking. One patient had never smoked, and the other was an ex-smoker who started small amount smoking 2 years ago but quitted 1 year ago. Pneumonia-like respiratory symptoms were improved after high-dose systemic steroid applied. After an 8-week cessation of cigarette smoking, one of them has resumed smoking 10~20 pieces per day again. He did not experience any symptom except flu-like symptoms on the seventh day. Chest radiographs showed no infiltration, and flu-like symptoms subsided without any specific therapy. This suggests that cigarette smoking led to AEP in this patient and tolerance might develop against chronic repeated resumption of smoking cigarettes. We should pay attention to awareness of cigarette smoking-induced AEP, especially among the younger generation who started smoking recently.

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