International Journal of Pharma and Bio Sciences
    ISSN 0975-6299

Int J Pharm Bio Sci Volume 14 Issue 4, October - December, Pages:38-48

Idiopathic Chronic Eosinophilic Pneumonia: A Rare Condition

Huma Firdaus,Shadan sadaf;Maqsumi Reza

Respirational and universal indications that be chronic or acute, blood and alveolar eosinophilia, and distal respiratory infiltrates on chest imaging describe idiopathic-chronic-eosinophilic-pneumonia (ICEPn). Most individuals have eosinophilia, which is generally more than 1000/mm3. The lack of substantial blood eosinophilia syndrome reinforces an identification of ICEPn. Eosinophilia in the Bronchoa-Alveolar-Lavage(BrAL) is usually linked with elevated eosinophil levels. ICEPn is an uncommon condition with an unknown origin. Its precise prevalence needs to be clarified. ICEPn can affect anybody at any age, although it is more common in children. It affects women twice as much as males. Asthma affects one-third to one-half of all ICEPn patients. Systemic corticosteroids are the source of ICEPn therapy. Outlying blood eosinophilia may be evident during the initial case presentation, but it might be missing or delayed, particularly in smoking-related AEPn. Our review is focused on ICEPn, Lung Diseases, Chest Imaging, Pathogenesis, and Pathology. The basis of treating AEPn of non-infectious etiology is the termination of exposure to the inciting substance (e.g., smoking) and glucocorticoids. If AEPn is identified and treated promptly, the prognosis is typically favorable, with early and full clinical recovery.

Keywords: Idiopathic-Chronic-Eosinophilic-Pneumonia-(ICEPn), Respiratory Distress, Lung Diseases, Chest Imaging, Pathogenesis and Pathology
Full HTML:


  1. Fernández Pérez ER, Olson AL, Frankel SK. SKEosinophilic lung diseases. Med Clin North Am. 2011;95(6):1163-87. doi: 10.1016/j.mcna.2011.08.006, PMID 22032433.
  2. Danila E, Nork?nien? J, Narg?la R, ┼Żurauskas E, Šatkauskas B, Aleksonien? R. Manifestation peculiarities of idiopathic chronic eosinophilic pneumonia. Open Med. 2010 Feb 1;5(1):75-82. doi: 10.2478/s11536-009-0082-x.
  3. Zhao L, Luo JL, Ali MK, Spiekerkoetter E, Nicolls MR. The human respiratory microbiome: current understandings and future directions. Am J Respir Cell Mol Biol. 2023 Mar;68(3):245-55. doi: 10.1165/rcmb.2022-0208TR, PMID 36476129.
  4. Asano K, Suzuki Y, Tanaka J, Kobayashi K, Kamide Y. Treatments of refractory eosinophilic lung diseases with biologics. Allergol Int. 2023;72(1):31-40. doi: 10.1016/j.alit.2022.10.004, PMID 36333218.
  5. Grando M, De Pauli S, Miotti G, Balbi M, Zeppieri M. Adult eosinophilic esophagitis and advances in its treatment. World J Methodol. 2023 Jun 20;13(3):59-66. doi: 10.5662/wjm.v13.i3.59, PMID 37456973.
  6. Cho M, Hostoffer R. Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. J Osteopath Med. 2023 Jun 30;0. doi: 10.1515/jom-2023-0037, PMID 37382386.
  7. Silva AFG, Melro LMG, Besen BAMP, Mendes PV, Park M. Pneumonia eosinofílica aguda induzida por sulfonamida que requer suporte de oxigenação por membrana extracorpórea: relato de caso. Crit Care Sci. 2023 Aug 7;35(2):239-42. doi: 10.5935/2965-2774.20230404-pt.
  8. Murillo AD, Castrillon AI, Serrano CD, Fernandez-Trujillo L. Monoclonal antibodies in idiopathic chronic eosinophilic pneumonia: A scoping review.
  9. Worku E, Adam Worku D. Atraumatic splenic rupture in Legionella pneumophila pneumonia. Case Rep Infect Dis. 2023 Jun 7;2023:9625170. doi: 10.1155/2023/9625170, PMID 37323130.
  10. Nehme R, Samaha D, Al Haddad Y. A case of relapsing chronic eosinophilic pneumonia treated by omalizumab. Respir Med Case Rep. 2023 Jan 1;41:101796. doi: 10.1016/j.rmcr.2022.101796, PMID 36583062.
  11. Valent P, Klion AD, Horny HP, Roufosse F, Gotlib J, Weller PF, et al. Contemporary consensus proposal on criteria and classification of eosinophilic disorders and related syndromes. J Allergy Clin Immunol. 2012;130(3):607-612.e9. doi: 10.1016/j.jaci.2012.02.019, PMID 22460074.
  12. Cottin V, Cordier JF. Eosinophilic pneumonia. In: Cottin V, Cordier JF, Richeldi L, editors. Orphan lung diseases: a clinical guide to rare lung disease. London: Springer-Verlag; 2015. p. 227-51.
  13. Cottin V, Cordier JF. Eosinophilic pneumonia. In: Mason RJ, Ernst JD, King TE Jr, et al., editors. Murray and Nadel’s textbook of respiratory medicine. 6th ed. Amsterdam: Elsevier Saunders; 2016. p. 1221-42.
  14. Gun E, Bugra A. Eosinophilic myocarditis from a forensic histopathological perspective. J Forensic Sci. 2023 Mar;68(2):500-8. doi: 10.1111/1556-4029.15197, PMID 36633063.
  15. Misaki Y, Hayashi Y, Shirata M, Terada K, Yoshizawa A, Sakamoto R et al. Resolution of eosinophilic pneumonia after coronavirus disease 2019 without systemic corticosteroids. Intern Med. 2023:1648-23. doi: 10.2169/internalmedicine.1648-23, PMID 37587039.
  16. Allam VSRR, Waern I, Taha S, Akula S, Wernersson S, Pejler G. Nafamostat has anti-asthmatic effects associated with suppressed pro-inflammatory gene expression, eosinophil infiltration and airway hyperreactivity. Front Immunol. 2023 Apr 21;14:1136780. doi: 10.3389/fimmu.2023.1136780, PMID 37153590.
  17. Nore KG. The Eicosanoid system–effects on pathogenesis and potential as targets for Host Directed Therapy in tuberculosis.
  18. Kolkhir P, Akdis CA, Akdis M, Bachert C, Bieber T, Canonica GW et al. Type 2 chronic inflammatory diseases: targets, therapies and unmet needs. Nat Rev Drug Discov. 2023 Aug 1:1-25. doi: 10.1038/s41573-023-00750-1, PMID 37528191.
  19. Gurtner A, Crepaz D, Arnold IC. Emerging functions of tissue-resident eosinophils. J Exp Med. 2023 Jun 16;220(7):e20221435. doi: 10.1084/jem.20221435, PMID 37326974.
  20. Fathi S, Lei IM, Cao Y, Huang YYS. Microcapillary cell extrusion deposition with picolitre dispensing resolution. Biodes Manuf. 2023;6(1):1-11. doi: 10.1007/s42242-022-00205-3. PMID 36644556.
  21. Stawiarski K, Thakkar A, Hahn V, Gilotra N, Riley S, Kang J et al. Sulfasalazine hypersensitivity reaction induced eosinophilic myocarditis. J Card Fail. 2023 Apr 1;29(4):702-3. doi: 10.1016/j.cardfail.2022.10.389.
  22. Carrington CB, Addington WW, Goff AM, Madoff IM, Marks A, Schwaber JR, et al. Chronic eosinophilic pneumonia. N Engl J Med. 1969;280(15):787-98. doi: 10.1056/NEJM196904102801501, PMID 5773637.
  23. Kang BH, Lee DH, Roh MS, Um SJ, Kim I. Acute eosinophilic pneumonia after combined use of conventional and heat-not-burn cigarettes: A case report. Medicina (Kaunas). 2022 Oct 26;58(11):1527. doi: 10.3390/medicina58111527, PMID 36363483.
  24. Thomeer MJ, Costabe U, Rizzato G, Poletti V, Demedts M. Comparison of registries of interstitial lung diseases in three European countries. Eur Respir J Suppl. 2001;32:114s-8s. PMID 11816817.
  25. Marchand E, Reynaud-Gaubert M, Lauque D, Durieu J, Tonnel AB, Cordier JF. Idiopathic chronic eosinophilic pneumonia. A clinical and follow-up study of 62 cases. The Groupe d’Etudes et de Recherche sur les Maladies “Orphelines” Pulmonaires (GERM”O”P). [The Groupe d’Etudes et de Recherche sur les Maladies ”Orphelines” Pulmonaires (GERM ’O’ P)]. Med (Baltim). 1998;77(5):299-312. doi: 10.1097/00005792-199809000-00001, PMID 9772920.
  26. Jederlinic PJ, Sicilian L, Gaensler EA. Chronic eosinophilic pneumonia. A report of 19 cases and a review of the literature. Med (Baltim). 1988;67(3):154-62. doi: 10.1097/00005792-198805000-00002, PMID 3285120.
  27. Mikami E, Atsumi K, Iso H, Suzuki T, Matsuki S, Hisakane K et al. Development of eosinophilic pneumonia from eosinophilic bronchiolitis without asthma: A case report. Respir Med Case Rep. 2023 Jul 23;45:101901. doi: 10.1016/j.rmcr.2023.101901, PMID 37577123.
  28. Koroleva I. MDCT in the diagnosis of pulmomary infiltration with eosinophilia (PIE-syndrom). European Congress of Radiology-ESTI ESCR; 2018.
  29. Sade K, Mysels A, Levo Y, Kivity S. Eosinophilia: a study of 100 hospitalized patients. Eur J Intern Med. 2007 May 1;18(3):196-201. doi: 10.1016/j.ejim.2006.09.031, PMID 17449391.
  30. Mukherjee R, M B. Eosinophilic granulomatosis with polyangiitis (Churg Strauss Syndrome) – a case report. Digit J Clin Med;5(2):50-5. doi: 10.55691/2582-3868.1132.
  31. Challa A, Sirisha S, Khandelia H, Parekh M, Patil A, Jayalakshmi S. A case of eosinophilic granulomatous polyangiitis with concurrent central and peripheral nervous system involvement. Oxf Med Case Reports. 2023 Jul;2023(7):omad067. doi: 10.1093/omcr/omad067, PMID 37484549.
  32. Jeong YJ, Kim KI, Seo IJ, Lee CH, Lee KN, Kim KN et al. Eosinophilic lung diseases: a clinical, radiologic, and pathologic overview. RadioGraphics. 2007 May;27(3):617-37; discussion 637. doi: 10.1148/rg.273065051, PMID 17495282.
  33. Gaensler EA, Carrington CB. Peripheral opacities in chronic eosinophilic pneumonia: the photographic negative of pulmonary edema. AJR Am J Roentgenol. 1977;128(1):1-13. doi: 10.2214/ajr.128.1.1, PMID 401562.
  34. Bancal C, Sadoun D, Valeyre D, Roucou Y, Clerici C, Georges R, et al. Chronic idiopathic eosinophilic pneumopathy. Carrington’s disease. Presse Med. 1989;18(34):1695-8 [in French]. PMID 2534858.
  35. Zimhony O. Photographic negative shadow of pulmonary oedema. Lancet. 2002;360(9326):33. doi: 10.1016/S0140-6736(02)09329-7, PMID 12114038.
  36. Milos RI, Bartha C, Röhrich S, Heidinger BH, Prayer F, Beer L et al. Imaging in patients with acute dyspnea when cardiac or pulmonary origin is suspected. BJR Open. 2023 Mar;5(1):20220026. doi: 10.1259/bjro.20220026, PMID 37035768.
  37. Motokura Y, Ito A, Yokoe S, Iri O, Nishimura K, Kamiyama S et al. Pulmonary cryptococcosis diagnosed by a transbronchial lung cryobiopsy in a patient with rheumatoid arthritis. Intern Med. 2023 Feb 15;62(4):583-7. doi: 10.2169/internalmedicine.9764-22, PMID 35908974.
  38. Borgheresi A, Agostini A, Pierpaoli L, Bruno A, Valeri T, Danti G, et al. Tips and tricks in thoracic radiology for beginners: A findings-based approach. Tomography. 2023 Jun 14;9(3):1153-86. doi: 10.3390/tomography9030095, PMID 37368547.
  39. Rao K, Arustamyan M, Walling A, Christodoulidis G, Ashwath M, Hagedorn J et al. Utility of cardiac magnetic resonance imaging in diagnosing eosinophilic myocarditis in a patient recently recovered from COVID-19: a grand round case report. Eur Heart J Case Rep. 2023 Mar 1;7(3):ytad090. doi: 10.1093/ehjcr/ytad090, PMID 37006798.
  40. Dellal FD, Karaahmetli G, Guven SC, Aydin C, Topaloglu O, Ersoy R et al. Eosinophilic granulomatosis with polyangiitis as a rare cause of the syndrome of inappropriate antidiuretic hormone secretion. Ir J Med Sci. 2023 Jun;192(3):1171-6. doi: 10.1007/s11845-022-03107-6, PMID 35895178.
  41. Padhiyar J, Patel N, Lakum M, Shah H. Chronic oro-Genital ulcerations as a presenting feature of chronic eosinophilic leukemia: A case report. Indian Dermatol Online J. 2023 Jul;14(4):524-6. doi: 10.4103/idoj.idoj_477_22, PMID 37521217.
  42. Ono E, Taniguchi M, Mita H, Higashi N, Fukutomi Y, Tanimoto H, et al. Increased urinary leukotriene E4 concentration in patients with eosinophilic pneumonia. Eur Respir J. 2008;32(2):437-42. doi: 10.1183/09031936.00093407, PMID 18417515.
  43. Shimizudani N, Murata H, Kojo S, Adachi Y, Keino H, Tsuchida F, et al. Analysis of T cell receptor V(beta) gene expression and clonality in bronchoalveolar fluid lymphocytes from a patient with chronic eosinophilic pneumonitis. Lung. 2001;179(1):31-41. doi: 10.1007/s004080000045, PMID 11479692.
  44. Freymond N, Kahn JE, Legrand F, Renneville A, Cordier JF, Cottin V. Clonal expansion of T cells in patients with eosinophilic lung disease. Allergy. 2011;66(11):1506-8. doi: 10.1111/j.1398-9995.2011.02697.x, PMID 21883280.
  45. Hamie L, Hamie M, Kurban M, Abbas O. Eosinophilic ulcer of the oral mucosa: an update on clinicopathologic features, pathogenesis, and management. Int J Dermatol. 2022 Nov;61(11):1359-63. doi: 10.1111/ijd.15986, PMID 34812492.
  46. Schoeberlein MI, Frisiras CE, Coffman KE. The effect of heat on lung diffusing capacity for carbon monoxide (DLCO) during cycling exercise. Eur J Appl Physiol. 2023 Aug 7:1-9. doi: 10.1007/s00421-023-05280-7, PMID 37548661.
  47. Jlali I, Heyman E, Matran R, Marais G, Descatoire A, Rabasa?Lhoret R et al. Respiratory function in uncomplicated type 1 diabetes: blunted during exercise even though normal at rest! Diabet Med. 2023 May;40(5):e15036. doi: 10.1111/dme.15036, PMID 36585956.
  48. Miki K, Miki M, Nakamura Y, Suzuki Y, Okano Y, Ogushi F, et al. Early-phase neutrophilia in cigarette smoke-induced acute eosinophilic pneumonia. Intern Med. 2003;42(9):839-45. doi: 10.2169/internalmedicine.42.839, PMID 14518673.
  49. Nakagome K, Shoda H, Shirai T, Nishihara F, Soma T, Uchida Y, et al. Eosinophil transendothelial migration induced by the bronchoalveolar lavage fluid of acute eosinophilic pneumonia. Respirology. 2017;22(5):913-21. doi: 10.1111/resp.12982, PMID 28139852.
  50. De Giacomi F, Vassallo R, Yi ES, Ryu JH. Acute eosinophilic pneumonia. Causes, diagnosis, and management. Am J Respir Crit Care Med. 2018 Mar 15;197(6):728-36. doi: 10.1164/rccm.201710-1967CI, PMID 29206477.
  51. Vianello A, Guarnieri G, Achille A, Lionello F, Lococo S, Zaninotto M et al. Serum biomarkers of remodeling in severe asthma with fixed airway obstruction and the potential role of KL-6. Clin Chem Lab Med. 2023 Mar 30;61(10):1679-87. doi: 10.1515/cclm-2022-1323, PMID 36989607.
  52. Cabrera López C, Sánchez Santos A, Lemes Castellano A, Cazorla Rivero S, Breña Atienza J, González Dávila E et al. Eosinophil subtypes in adults with asthma and adults with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2023 Jul 15;208(2):155-62. doi: 10.1164/rccm.202301-0149OC, PMID 37071848.
  53. Patel A, Matta JG, Assaker JP, Kindle R. An unusual case of acute eosinophilic lung disease in the setting of adalimumab use. A3165-. The good. Times Higher Education British Association of Dermatologists. American Thoracic Society. 2023. doi: 10.1164/ajrccm-conference.2023.207.1_MeetingAbstracts.A3165.
  54. Naveed M, Azam Khan MN, Shah SU, Hussain A, Khan MS, Hussain MZ. Association of absolute eosinophil count and post-bronchodilator reversibility in the chronic obstructive pulmonary disease patients. Pak Armed Forces Med J. 2023 Apr 17;73(2):361-64. doi: 10.51253/pafmj.v73i2.4546.
  55. Sezen CB, Dogru MV, Tanr?kulu G, Aker C, Erduhan S, Saydam O et al. Comparison of short-term results of subxiphoid and conventional video-assisted thoracoscopic surgery in diagnostic wedge resections. Asian Cardiovasc Thorac Ann. 2023 Feb;31(2):115-22. doi: 10.1177/02184923221138307, PMID 36366742.
  56. Joërg L, Trouillon T, Jalaber C, Court Fortune I, Luchez A, Boutet C et al. Chest ultrasound findings in usual interstitial pneumonia patterns: a pilot study. Monaldi Arch Chest Dis. 2022;93(2). doi: 10.4081/monaldi.2022.2356. PMID 36069640.
  57. Collaro AJ. Aboriginal and Torres Strait Islander lung function: determinants, outcomes, and reference values ([doctoral dissertation]. Queensland University of Technology).
  58. Fox B, Seed WA. Chronic eosinophilic pneumonia. Thorax. 1980;35(8):570-80. doi: 10.1136/thx.35.8.570, PMID 7003796.
  59. Smith ML, Mino-Kenudson M, Butterfield RJ, Dacic S, Colby TV, Churg A et al. Pulmonary Pathology Society survey on practice approaches in the histologic diagnosis of fibrotic interstitial lung disease: consensus and opportunities. Arch Pathol Lab Med. 2023 May 23. doi: 10.5858/arpa.2022-0530-OA, PMID 37226833.
  60. Yuningtyaswari Y, Pramana PS. The effect of giving date powder (Phoenix dactylifera) on histopathology of pulmo alveoli. Asian J Healthy Sci. 2023 Feb 8;2(2):58-74. doi: 10.58631/ajhs.v2i2.28.
  61. Zagaceta W, Valverde M, Mathios J. Subserous eosinophilic colitis: A case report in a private hospital in Lima, Peru. Rev Colomb Gastroenterología. 2023 Mar;38(1):82-7.
  62. Solomon L, Modak K, Paul PAM, John J. A common presentation of an uncommon pathology: Kimura disease. Trop Doct. 2023 May 29:00494755231177487:494755231177487. doi: 10.1177/00494755231177487, PMID 37248672.
  63. Pneumotox on Line: the Drug-Induced Lung Diseases. Available from: [cited 22/8/2023].
  64. Greenberger PA. Allergic bronchopulmonary aspergillosis and fungoses. Clin Chest Med. 1988;9(4):599-608. doi: 10.1016/S0272-5231(21)00585-2, PMID 3069291.
  65. Hoermann J, Kuenzli E, Schaefer C, Paris DH, Bühler S, Odermatt P et al. Performance of a rapid immuno-chromatographic test (Schistosoma ICT IgG-IgM) for detecting Schistosoma-specific antibodies in sera of endemic and non-endemic populations. PLOS Negl Trop Dis. 2022 May 27;16(5):e0010463. doi: 10.1371/journal.pntd.0010463, PMID 35622871.
  66. Allen JN, Davis WB. Eosinophilic lung diseases. Am J Respir Crit Care Med. 1994;150(5 Pt 1):1423-38. doi: 10.1164/ajrccm.150.5.7952571, PMID 7952571.
  67. Adam S, Dekumyoy P, Nacapunchai D, Ketboonlue T, Charunwatthana P, Dhitavat J et al. Assessment of an immuno-diagnostic method for hookworm-related cutaneous larva migrans using crude extracts of Ancylostoma caninum. Trop Med Infect Dis. 2023 Mar 30;8(4):209. doi: 10.3390/tropicalmed8040209, PMID 37104335.
  68. Wechsler ME. Pulmonary eosinophilic syndromes. Immunol Allergy Clin North Am. 2007 Aug 1;27(3):477-92. doi: 10.1016/j.iac.2007.07.005, PMID 17868860.
  69. Waseem M, Laureta E. An asthmatic adolescent with a rash and eosinophilia. Pediatr Emerg Care. 2007 Oct 1;23(10):727-30. doi: 10.1097/PEC.0b013e3181568016, PMID 18090108.
  70. Gioia G. Appendicitis and gastric perforation in eosinophilic granulomatosis with polyangiitis: a case report. J Allergy Immunol. 2017;1(1). doi: 10.15761/JAI.1000106.
  71. Moss RB. Treating allergic bronchopulmonary aspergillosis: the way forward. Eur Respir J. 2016;47(2):385-7. doi: 10.1183/13993003.01816-2015. PMID 26828049.
  72. Singh Sehgal I, Agarwal R. Pulse methylprednisolone in allergic bronchopulmonary aspergillosis exacerbations. Eur Respir Rev. 2014;23(131):149-52. doi: 10.1183/09059180.00004813, PMID 24591674.
  73. Patterson R, Greenberger PA, Lee TM, Liotta JL, O’Neill EA, Roberts M, et al. Prolonged evaluation of patients with corticosteroid-dependent asthma stage of allergic bronchopulmonary aspergillosis. J Allergy Clin Immunol. 1987;80(5):663-8. doi: 10.1016/0091-6749(87)90285-5, PMID 3316345.
  74. Ali WM, Alhumaidi MS. Artificial intelligence for cancer diagnosis & radiology. Int J Trends Oncoscience. 2023 Feb 21:13-8.


[Download PDF]
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy
Pharmaceutical Fields
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Pharmaceutics
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Novel drug delivery system
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Nanotechnology
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Pharmacology
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Pharmacognosy
© Copyright 2009-2015 IJPBS, India. All rights reserved. Specialized online journals by ubijournal. Website by Ubitech Solutions
         Home I Contact I Terms & Conditions