Médecine pulmonaire et respiratoire

Eosinophilic Lung Diseases: From Diagnosis to Management

Abstract

Amelie Harle

Eosinophilic lung diseases encompass a group of conditions characterized by the accumulation of eosinophils in the lungs, leading to inflammation and tissue damage. These diseases can be broadly categorized into eosinophilic pneumonia, Eosinophilic Granulomatosis with Polyangiitis (EGPA), and Hypereosinophilic Syndrome (HES). Eosinophilic pneumonia includes acute and chronic forms, with symptoms such as cough, dyspnea, fever, and infiltrates on chest imaging. Causes may include infections, medications, or environmental exposures. EGPA, formerly known as Churg-Strauss syndrome, is a rare autoimmune condition characterized by asthma, eosinophilia, and systemic vasculitis affecting small to medium-sized blood vessels. It can involve multiple organs, including the lungs, leading to respiratory symptoms, such as cough, wheezing, and infiltrates on imaging. HES is a heterogeneous disorder characterized by persistent eosinophilia and organ damage. Lung involvement may manifest as cough, dyspnea, infiltrates, or fibrosis. Diagnosis of eosinophilic lung diseases involves clinical evaluation, laboratory tests (including blood eosinophil count), imaging studies (such as chest X-ray or CT scan), and sometimes lung biopsy. Treatment depends on the underlying cause and severity of the disease but often includes corticosteroids to reduce inflammation and suppress eosinophil activity. Other immunosuppressive agents may be used in refractory cases. Management may also involve treating underlying conditions, such as asthma or parasitic infections, and avoiding triggers, such as allergens or certain medications. Close monitoring and follow-up are essential to assess treatment response and disease progression.