Chronic eosinophilic pneumonia with mucous plugs in a child

Erkan Cakir, Ferda Aksoy, Fatma Betul Cakir

Author address: 

Pediatric Pulmonology, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Investigation Hospital, Istanbul, Turkey 2Pathology, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Investigation Hospital, Istanbul, Turkey 3Pediatric

Abstract: 

Aim: Eosinophilic lung diseases are a diverse group of pulmonary disorders. Chronic eosinophilic pneumonia is an extremely rare disease in childhood. Method: A seven year-old girl was admitted to our hospital with a history of persistent cough and sputum for 5 years. She had no history of chronic diarrhea, vomiting, infections rather than respiratory system. The history of family asthma, atopy and allergic diseases was negative. Results: She had wheezing and crackles bilaterally. Leucocyte count was 10500/mm3 with 21% eosinophils on differential count. Chest radiography and high-resolution chest computed tomography showed bilateral noduler opacities. Flexible bronchoscopy showed whitish mucous plugs obstructing left lower lobe anterobasal segment. BAL cytology examination showed 4.1x 105 cells/ml with a differential count of 51% eosinophils. Histopathologic examination of the mucous plugs and BAL demonstrated chronic inflammation with numerous eosinophils. There was no evidence of bacterial, fungal, tuberculosis or parasitic infections. Biochemical analysis was normal. Serum IgE measured 940 IU/mL. Allergen prick test was negative including aspergillus antigen. Aspergillus IgE and IgG, ANA, antidsDNA, cANCA, pANCA were negatif. Gaita microscopy was normal, there was no parasite and helmint eggs. Chronic eosinophilic pneumonia was confirmed after the elimination of other eosinophilic lung diseases and the case was accepted to be idiopathic. The patient was treated with methylprednisolone 2mg/kg/day for two months and then progressively tapered. The symptoms improved clinically and radiologically within two months. Conclusion: Chronic eosinophilic pneumonia should be kept in mind in refractory respiratory system diseases.
2010

abstract No: 

P2669

Full conference title: 

20th European Respiratory Society conference
    • ERS 20th (2010)