Acute eosinophilic pneumonia (AEP) is an uncommon inflammatory lung disease, and limited data exist concerning the clinical characteristics and factors that influence its occurrence. We retrospectively reviewed the records of AEP patients treated at Korean military hospitals between January 2007 and December 2013. In total, 333 patients were identified; their median age was 22 years, and all were men. All patients presented with acute respiratory symptoms (cough, sputum, dyspnea, or fever) and had elevated levels of inflammatory markers including median values of 13,185/microL for white blood cell count and 9.51 mg/dL for C-reactive protein. All patients showed diffuse ground glass opacity/consolidation, and most had pleural effusion (n = 265; 80%) or interlobular septal thickening (n = 265; 85%) on chest computed tomography. Most patients had normal body mass index (n = 255; 77%), and only 30 (9%) patients had underlying diseases including rhinitis, asthma, or atopic dermatitis. Most patients had recently changed smoking habits (n = 288; 87%) and were Army personnel (n = 297; 89%).The AEP incidence was higher in the Army group compared to the Navy or Air Force group for every year (P = 0.002). Both the number of patients and patients with high illness severity (oxygen requirement, intensive care unit admission, and pneumonia severity score class > or = III) tended to increase as seasonal temperatures rose. We describe the clinical characteristics of AEP and demonstrate that AEP patients have recently changed smoking habits and work for the Army. There is an increasing tendency in the numbers of patients and those with higher AEP severity with rising seasonal temperatures.
Acute Disease ; Asian Continental Ancestry Group ; C-Reactive Protein/analysis ; Cough/etiology ; Dyspnea/etiology ; Fever/etiology ; Humans ; Incidence ; Leukocyte Count ; Male ; Military Personnel ; Pleural Effusion/complications/diagnosis/radiography ; Pulmonary Eosinophilia/complications/*diagnosis/pathology ; Republic of Korea/epidemiology ; Retrospective Studies ; Seasons ; Severity of Illness Index ; Smoking ; Tomography, X-Ray Computed ; Young Adult

BACKGROUND/AIMS: Eosinophilic gastroenteritis (EG) is a rare disease characterized by prominent eosinophilic infiltration that may involve a variable depth of one or more gastrointestinal organs. We analyzed the largest number of patients with EG among the studies carried out at a single center in Korea. METHODS: We retrospectively analyzed the clinical, laboratory, endoscopic, and radiologic features, management, and clinical outcome in 17 patients who were diagnosed as EG from January 1994 to Febuary 2008. RESULTS: Median age was 36 (2-67 years). Two of the 17 patients had a history of allergy. The most common symptoms were abdominal pain and diarrhea. Fifteen patients (88.2%) had hypereosinophilia. The ESR was moderately raised in 6 out of 14 patients. Eleven patients (64.7%) had predominant involvement of the mucosa, 1 (5.9%) of muscularis, and 5 (29.4%) of subserosa. EGD revealed non-specific findings such as erythema and edema. Abdominal Computed tomography revealed gastrointestinal wall thickenings of the involved organ, and all of 5 cases of the subserosal type had ascites. Thirteen patients (76.5%) were improved by corticosteroid treatment. Among five patients who had been followed for more than one year (12-84 months), two experienced relapse after discontinuing corticosteroids. CONCLUSIONS: EG should be considered in the differential diagnosis of unexplained gastrointestinal symptoms even in the absence of peripheral eosinophilia and in non-specific endoscopic findings.
Adolescent ; Adrenal Cortex Hormones/therapeutic use ; Adult ; Aged ; Azathioprine/therapeutic use ; Child ; Child, Preschool ; Diagnosis, Differential ; Endoscopy, Digestive System ; Eosinophilia/complications/*diagnosis/radiography ; Female ; Gastroenteritis/*diagnosis/drug therapy/radiography ; Humans ; Immunosuppressive Agents/therapeutic use ; Male ; Middle Aged ; Recurrence ; Retrospective Studies ; Tomography, X-Ray Computed

In 1932, Loffler described a syndrome of self-limiting, transient pulmonary infiltrates associated with peripheral blood eosinophilia and mild pulmonary symptoms. A number of conditions are related to pulmonary eosinophilia or pulmonary infiltration with eosinophilia. Especially, parasitic infestations are often related to pulmonary eosinophilia, but only two cases associated with Clonorchis sinensis have been anecdotally reported in English literature. Here we report a case of migrating pulmonary eosniophilic infiltrations associated with Clonorchis sinensis that was successfully treated with praziquantel. Clonorchiasis should be considered in patients with marked eosinophilia and pulmonary infiltrations.
Animals ; Biopsy ; Clonorchiasis/*complications/*diagnosis ; Clonorchis sinensis/*isolation & purification ; Human ; Male ; Middle Aged ; Pulmonary Eosinophilia/*etiology/pathology/radiography ; Syndrome