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Bay P, Groh M, Gaillet A, Schmidt M, Luyt CE, Combes A, Pineton de Chambrun M. Extracorporeal membrane oxygenation for refractory acute eosinophilic pneumonia. J Crit Care 2024; 79:154437. [PMID: 37782978 DOI: 10.1016/j.jcrc.2023.154437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 09/19/2023] [Accepted: 09/24/2023] [Indexed: 10/04/2023]
Affiliation(s)
- Pierre Bay
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital La Pitié-Salpêtrière, Institut de Cardiologie; Service de Médecine Intensive-Réanimation, Paris, France; Service de Médecine Intensive-Réanimation, Hôpitaux Universitaires Henri Mondor - Albert Chenevier, AP-HP, Créteil, France; UPEC (Université Paris Est), INSERM, Unité U955, équipe 18, 94010 Créteil, France
| | - Matthieu Groh
- Service de Médecine Interne, Centre National de Référence des Syndromes Hyperéosinophiliques (CEREO), Hôpital Foch, Suresnes, France
| | - Antoine Gaillet
- Service de Médecine Intensive-Réanimation, Hôpitaux Universitaires Henri Mondor - Albert Chenevier, AP-HP, Créteil, France; Service de Médecine Interne, Centre National de Référence des Syndromes Hyperéosinophiliques (CEREO), Hôpital Foch, Suresnes, France
| | - Matthieu Schmidt
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital La Pitié-Salpêtrière, Institut de Cardiologie; Service de Médecine Intensive-Réanimation, Paris, France; Sorbonne Université, INSERM, UMRS_1166-ICAN, Institut de Cardiométabolisme et Nutrition (ICAN), Paris, France
| | - Charles-Edouard Luyt
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital La Pitié-Salpêtrière, Institut de Cardiologie; Service de Médecine Intensive-Réanimation, Paris, France; Sorbonne Université, INSERM, UMRS_1166-ICAN, Institut de Cardiométabolisme et Nutrition (ICAN), Paris, France
| | - Alain Combes
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital La Pitié-Salpêtrière, Institut de Cardiologie; Service de Médecine Intensive-Réanimation, Paris, France; Sorbonne Université, INSERM, UMRS_1166-ICAN, Institut de Cardiométabolisme et Nutrition (ICAN), Paris, France
| | - Marc Pineton de Chambrun
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital La Pitié-Salpêtrière, Institut de Cardiologie; Service de Médecine Intensive-Réanimation, Paris, France; Sorbonne Université, INSERM, UMRS_1166-ICAN, Institut de Cardiométabolisme et Nutrition (ICAN), Paris, France; Sorbonne Université, AP-HP, Hôpital La Pitié-Salpêtrière, Institut E3M, Service de Médecine Interne 2, Centre de Référence National Lupus Systémique, Syndrome des Anticorps Anti-phospholipides et Autres Maladies Auto-Immunes Systémiques Rares, Paris, France; Sorbonne Université, Inserm, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), and AP-HP, Hôpital La Pitié-Salpêtrière, Département d'Immunologie, Paris, France.
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Silva AFG, Melro LMG, Besen BAMP, Mendes PV, Park M. Sulfonamide-induced acute eosinophilic pneumonia requiring extracorporeal membrane oxygenation support: a case report. CRITICAL CARE SCIENCE 2023; 35:239-242. [PMID: 37712817 PMCID: PMC10406408 DOI: 10.5935/2965-2774.20230404-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/26/2023] [Indexed: 09/16/2023]
Affiliation(s)
- Ana Flávia Garcia Silva
- Intensive Care Unit, Emergence Department, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo - São Paulo (SP), Brazil
| | - Lívia Maria Garcia Melro
- Intensive Care Unit, Emergence Department, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo - São Paulo (SP), Brazil
| | | | - Pedro Vitale Mendes
- Intensive Care Unit, Emergence Department, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo - São Paulo (SP), Brazil
| | - Marcelo Park
- Intensive Care Unit, Emergence Department, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo - São Paulo (SP), Brazil
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Baqir M, Peikert T, Johnson TF, Tandon YK, Yi ES, Schroeder DR, Ryu JH. Idiopathic Chronic Eosinophilic Pneumonia Evolving to Pulmonary Fibrosis: A Retrospective Analysis. SARCOIDOSIS, VASCULITIS, AND DIFFUSE LUNG DISEASES : OFFICIAL JOURNAL OF WASOG 2022; 39:e2022020. [PMID: 36118537 PMCID: PMC9437755 DOI: 10.36141/svdld.v39i2.12656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 06/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Patients with idiopathic chronic eosinophilic pneumonia (ICEP) may have pulmonary fibrosis. OBJECTIVES To investigate the predictors of pulmonary fibrosis in ICEP, to describe the timeline of pulmonary fibrosis after ICEP diagnosis, and to detail the radiologic pattern of fibrosis. METHODS A retrospective computer-assisted search was performed to identify patients with ICEP seen at Mayo Clinic in Rochester, Minnesota, from January 1, 1997, through September 1, 2019. Patients with follow-up chest computed tomography (CT) beyond 12 months after the ICEP diagnosis were included in the study. Demographic, clinical, radiologic, and histopathologic characteristics were analyzed. Proportional hazards regression was used to assess the predictors of pulmonary fibrosis. RESULTS We identified 62 patients (mean [SD] age at ICEP diagnosis, 60 [13] years; female sex, 37 [60%]). Cough (87%) and shortness of breath (85%) were the most common presenting symptoms. Of patients, 27 (44%) had a history of smoking and 27 (44%) had a history of asthma. During follow-up, 23 patients (37%) had CT evidence of pulmonary fibrosis, of whom 16 patients (70%) had a CT pattern inconsistent with usual interstitial pneumonia. In 29% of the patients, the CT evidence of pulmonary fibrosis developed within 2 years after ICEP. Age and male sex were predictors of pulmonary fibrosis. Of note, a history of asthma decreased the likelihood of pulmonary fibrosis. CONCLUSIONS Development of pulmonary fibro-sis is not uncommon in patients with ICEP, especially older men, and is associated with increased risk of death.
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Affiliation(s)
- Misbah Baqir
- Division of Pulmonary and Critical Care Medicine, Rochester, Minnesota, USA
| | - Tobias Peikert
- Division of Pulmonary and Critical Care Medicine, Rochester, Minnesota, USA
| | | | | | - Eunhee S. Yi
- Division of Anatomic Pathology, Rochester, Minnesota, USA
| | - Darrell R. Schroeder
- Division of Clinical Trial and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
| | - Jay H. Ryu
- Division of Pulmonary and Critical Care Medicine, Rochester, Minnesota, USA
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Van Oortegem A, Meurice JC, Verdaguer M, Bironneau V. [Case report of severe acute eosinophilic pneumonia induced by amoxicillin]. Rev Mal Respir 2021; 38:524-529. [PMID: 33902969 DOI: 10.1016/j.rmr.2021.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 03/08/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Acute eosinophilic pneumonia (AEP) is a rare and potentially severe disorder, characterized by an acute febrile respiratory illness with diffuse pulmonary infiltrates, pleural effusions and an eosinophilic alveolitis identified on broncho-alveolar lavage or lung biopsy. The condition can be idiopathic, or induced by the inhalation of toxic substances, by infections or by medications. The condition tends to respond rapidly to treatment with systemic steroids. CASE REPORT We report the case of a 16-year old patient who presented severe acute interstitial pneumonia with eosinophilia (1.17g/L). They had taken a seven-day course of amoxicillin treatment two weeks previously for a dental abscess. The patient initially required respiratory support by mechanical ventilation followed by extracorporeal membrane oxygenation due to severe refractory hypoxemia. After exhaustive investigation a diagnosis of amoxicillin-induced acute eosinophilic pneumonia was made. After steroid treatment was initiated the clinical response was rapidly favorable and remission was achieved. The patient has been advised to avoid beta lactam antibiotics for life. CONCLUSION This case illustrates a rare case of severe acute eosinophilic pneumonia induced by amoxicillin.
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Affiliation(s)
- A Van Oortegem
- Service de pneumologie, Centre Hospitalier Universitaire, 6, rue de la Milétrie, 86000 Poitiers, France.
| | - J-C Meurice
- Service de pneumologie, Centre Hospitalier Universitaire, 6, rue de la Milétrie, 86000 Poitiers, France
| | - M Verdaguer
- Service de pneumologie, Centre Hospitalier Universitaire, 6, rue de la Milétrie, 86000 Poitiers, France
| | - V Bironneau
- Service de pneumologie, Centre Hospitalier Universitaire, 6, rue de la Milétrie, 86000 Poitiers, France
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Spaulding KH, Ng PC, April MD. Idiopathic acute eosinophilic pneumonia: A rare cause of hypoxic respiratory failure. Am J Emerg Med 2019; 37:2264.e1-2264.e3. [PMID: 31427164 DOI: 10.1016/j.ajem.2019.158386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 07/31/2019] [Accepted: 08/04/2019] [Indexed: 12/01/2022] Open
Abstract
Idiopathic Acute Eosinophilic Pneumonia (IAEP) is a life-threatening cause of hypoxic respiratory failure. IAEP is challenging to diagnose as it may mimic infectious pneumonia or acute respiratory distress syndrome. Distinguishing IAEP from these alternatives is important; the mainstay of treatment for IAEP is corticosteroids, a therapy which might not otherwise be indicated. Patients treated appropriately usually experience a full recovery. In this case report we describe the presentation, evaluation, and management of a 19-year old male who presented to the emergency department (ED) in respiratory failure from IAEP. The patient was a military trainee who recently moved to the United States from Saudi Arabia. He also recently began smoking cigarettes for the first time, a known risk factor for IAEP. Upon initial presentation, the patient was in respiratory distress and had an oxygen saturation of 82% on room air. His ED diagnostic workup included chest X-ray showing diffuse interstitial thickening and chest computed tomography that demonstrated diffuse nodular opacification of pulmonary parenchyma. The patient was admitted to the intensive care unit (ICU) where bronchoscopy yielded cytology with 30% eosinophilia. The patient ultimately required 3 days of extra corporeal membrane oxygenation (ECMO) due to worsening hypoxic respiratory failure. After both intravenous and outpatient oral steroid treatments, the patient went on to have a full recovery with no ongoing respiratory issues. To our knowledge, this is the first case of IAEP requiring ECMO reported in the emergency medicine literature.
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Affiliation(s)
- Kole H Spaulding
- Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, United States of America.
| | - Patrick C Ng
- Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, United States of America
| | - Michael D April
- Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, United States of America
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