Disease Information for Loeffler's Eosinophilic Pneumonitis, acute/PIE

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Clinical Manifestations
Signs & Symptoms
Bronchospasm signs
Cough
Cough Dry Non-productive
Dullness to percussion lung base
Dyspnea
Dyspnea at rest
Dyspnea on exertion
Localized decreased breath sounds
Localized dullness to percussion
Lung signs/abnormality
Rales
Rapid Breathing
Shortness of breath/SOB
Tachypnea/Increased respiratory rate
Wheezing
Constitutional symptoms
Fever
Fever Febrile Possible
Flu-Like Syndrome
High body temperature
Clinical Presentation & Variations
Presentation/Wheeze Cough Dyspnea Adult
Disease Progression
Course/Acute
Course/Acute on subacute
Course/Acute only
Course/Subacute
Demographics & Risk Factors
Established Disease Population
Patient/Allergic/atopic
Laboratory Tests
Abnormal Lab Findings (Non Measured)
Acute inflammatory markers elevated (Lab)
Abnormal Lab Findings - Increased
Eosinophiles (LAB)
WBC
Globulin, serum (Lab)
WBC/White Blood Cell Count/Leukocytes (Lab)
PLEURAL Eosinophiles
Diagnostic Test Results
X-RAY
Xray/Chest abnormal
Xray/Chest/Lung fields/Abnormal
Xray/Fluffy bilateral patchy infiltrates
Xray/Infiltrate, pulmonary/Chest
Xray/Interstitial infiltrate, acute/Chest
Xray/Interstitial infiltrate/fibrosis/Chest
Xray/Lung consolidation/Chest
Xray/Migratory patchy infiltrate/Chest
Xray/Patchy bilateral infiltrate/viral-like/Chest
Xray/Patchy infiltrate/Chest
Xray/Pleural fluid/Chest
Xray/Pneumonitis/pattern no infection/Chest
Xray/Pulmonary infiltrate eosinophilia (PIE/Loeffler's syndrome)
Xray/Pulmonary infiltrates, recurrent/Chest
Xray/Pulmonary Lesions/Lung
Xray/Transient pulmonary infiltrates/Chest
Associated Diseases & Rule outs
Rule Outs
Ascariasis
Ascariasis, pulmonary larval infestation
Churg Strauss pulmonary vasculitis
Pneumonia
Pneumonia, recurrent
Pneumonia, viral
Pneumonia/Bronchopneumonia
Sarcoidosis, pulmonary
Associated Disease & Complications
Allergic alveolitis
Aspergillosis, mycetoma type, pulmonary
Asthma
Eosinophilia Hypereosinophilia
Hypereosinophilic syndrome
Hyperglobulinemia
Hypersensitivity pneumonitis
Leukocytosis
Loefflers/Eosinophilic pneumonia, acute
Pleural Effusion
Pneumonia, recurrent
Pneumonia/Bronchopneumonia
Disease Mechanism & Classification
Class
CLASS/Lung Disorder (ex)
CLASS/Pulmonic (category)
Pathophysiology
Pathophysiology/Allergic-infectious agent response
Pathophysiology/Alveolar consolidation
Pathophysiology/Bronchospasm
Process
PROCESS/Allergy/collagen/autoimmune (category)
PROCESS/Eosinophilic syndromes (ex)
Synonyms
Synonym
Andrews syndrome, EOSINOPHILIA PULM, Eosinophilia Pulmonary, EOSINOPHILIAS PULM, Eosinophilias Pulmonary, Eosinophilic asthma, eosinophilic pneumonitis, PIE, PIE Pul infil + eosinophilia, PIE Pulmonary infiltrates with eosinophilia, PNEUMONITIS EOSINOPHILIC, PULM EOSINOPHILIA, PULM EOSINOPHILIAS, Pulm infiltrate + eosinophilia, Pulmonary eosinophilia, Pulmonary eosinophilia (disorder), Pulmonary Eosinophilias, Pulmonary infiltrates with eosinophilia, PULMONARY INFILTRATION EOSINOPHILIA, Synonym/Allergic interstitial pneumonitis, Synonym/Extrinsic allergic alveolitis, Synonym/PIE syndrome, Synonym/Pneumonia, allergic eosinophilic, Synonym/Pneumonia, eosinophilic, Synonym/Pulmonary eosinophilic infiltrate/PIE synd, Synonym/Pulmonary infiltration eosinophilia
Treatment
Drug Therapy - Indication
RX/Corticosteroid (Cortisone)
RX/Dexamethasone (Decadron)
RX/Epinephrine (Adrenalin)
Other Treatments
TX/Avoidance offending agents (indication).
Definition

Eosinophilia and pulmonary infiltrate (PIE) is Loeffler"s syndrome with many causes; allergic pneumonitis usually from extrinsic allergens; for long diagnostic cause list see attribute Loeffler"s syndrome (PIE); usually treatment includes steroids; can be severe with fibrosis if antigen exposure is recurrent; hypersensitivity pneumonitis is a more acute variation;------------------------------ diseases of known or unknown etiology characterized by eosinophilic pulmonary infiltrates and, commonly, peripheral blood eosinophilia; Eosinophilic pneumonia is sometimes called the pulmonary infiltrates with eosinophilia (PIE) syndrome; Causes include parasites (eg, roundworms, Toxocara larvae, filariae), drugs (eg, penicillin, aminosalicylic acid, hydralazine, nitrofurantoin, chlorpropamide, sulfonamides), chemical sensitizers (eg, nickel carbonyl inhaled as a vapor), and fungi (eg, Aspergillus fumigatus, which causes allergic bronchopulmonary aspergillosis; Most eosinophilic pneumonias, however, are of unknown etiology, although a hypersensitivity mechanism is suspected; Eosinophilia suggests a type I hypersensitivity reaction; other features of the syndrome (vasculitis, round cell infiltrates) suggest type III and possibly type IV reactions;

Eosinophilic pneumonias are often associated with bronchial asthma; Those associated with asthma and those of unknown etiology can be classified into three general groups: extrinsic bronchial asthma with the PIE syndrome, which often is allergic bronchopulmonary aspergillosis; intrinsic bronchial asthma with the PIE syndrome (chronic eosinophilic pneumonia), commonly with characteristic peripheral infiltrates on chest x-ray; and allergic granulomatosis (Churg-Strauss syndrome), a variant of polyarteritis nodosa with a predilection for the lungs; [Acute]Simple eosinophilic pneumonia (Löffler"s syndrome) may occasionally be associated with mild asthma; Eosinophilic pneumonias not associated with asthma include acute eosinophilic pneumonia, the eosinophilia-myalgia syndrome, and the hypereosinophilic syndrome; Acute eosinophilic pneumonia, a distinct entity of unknown cause, results in acute fever, severe hypoxemia, diffuse pulmonary infiltrates, and > 25% eosinophils in bronchoalveolar lavage fluid; it resolves promptly and completely with corticosteroid therapy; [Merck Manual 17th]

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External Links Related to Loeffler's Eosinophilic Pneumonitis, acute/PIE
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PubMed (National Library of Medicine)
NGC (National Guideline Clearinghouse)
Medscape (eMedicine)
Harrison's Online (accessmedicine)
NEJM (The New England Journal of Medicine)
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