Allergy, Asthma & Immunology Research  2013;5(4):242-244

doi:10.4168/aair.2013.5.4.242

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

Hwa Yong SHIN 1 ; Ju Won CHOE ; Minsuk KWON ; Ju Young JANG ; Jae Woo JUNG ; Jae Chol CHOI ; Jong Wook SHIN ; In Won PARK ; Byoung Whui CHOI ; Jae Yeol KIM

Affiliations

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Keywords

Acute eosinophilic pneumonia; respiratory failure; corticosteroid

Country

Republic of Korea

Language

English

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.