Chronic Eosinophilic Pneumonia: A Diagnostic Challenge

CEP has since been defined as an idiopathic chronic condition marked by alveolar filling with mixed inflammatory infiltrate, consisting largely of eosinophils.2 CEP characteristically affects patients in their third or fourth decade of life, with an insidious presentation of fever, weight loss, night sweats, chronic dry cough, and progressive shortness of breath over the course of months.3 Peripheral eosinophilia is typically pronounced, and IgE levels may be elevated.PFTs bestow limited diagnostic utility, and surgical lung biopsy is generally reserved for cases of diagnostic uncertainty.3 The hallmark of CEP is a profound and rapid response to oral corticosteroids, often within 48 hours.The average duration of symptoms in CEP is 7.7 months before a diagnosis is made,3 suggesting that improved recognition of its characteristic clinical and radiographic features may help avoid significant morbidity and potential mortality. 1 C.B. Carrington, W.W. Addington, A.M. Goff, I.M. Madoff, A. Marks, J.R. Schwaber, Chronic eosinophilic pneumonia, N Engl J Med, Vol. 280, 1969, 787-798 2 J.N. Allen, W.B. Davis, Eosinophilic lung diseases, Am J Respir Crit Care Med, Vol. 150, 1994, 1423-1438 3 E. Marchand, M. Reynaud-Gaubert, D. Lauque, J. Durieu, A.B. Tonnel, J.F. Cordier, Medicine (Baltimore), Vol. 77, 1998, 299-312