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Eosinophilic alveolitis in immunologic interstitial lung disorders
D Olivieri1, A Pesci, G Bertorelli
1Istituto di Clinica delle Malattie dell'Apparato Respiratorio Università degli Studi di Parma, Italy.
Lung
|January 1, 1990
Summary
Eosinophilic alveolitis, characterized by high eosinophil levels in bronchoalveolar lavage (BAL), is specifically linked to chronic eosinophilic pneumonia (CEP) and Churg-Strauss syndrome (CSS). Other interstitial lung diseases show mixed patterns with lower eosinophil increases.
Area of Science:
- Pulmonology
- Immunology
- Pathology
Background:
- Interstitial lung diseases (ILDs) involve immune mechanisms.
- Eosinophils play a role in certain ILDs, but their specific contribution to alveolitis requires clarification.
Purpose of the Study:
- To analyze the role of eosinophils in alveolitis across various immunologic interstitial lung diseases.
- To differentiate between true eosinophilic alveolitis and mixed patterns of lung inflammation.
Main Methods:
- Analysis of bronchoalveolar lavage (BAL) fluid from 537 patients with 13 types of ILD.
- Assessed eosinophil percentage in BAL, using a 4% cut-off.
- Correlated BAL eosinophil levels with blood eosinophil counts and other inflammatory cells.
Main Results:
- Five ILDs showed BAL eosinophilia >4%: idiopathic pulmonary fibrosis (IPF), allergic bronchopulmonary aspergillosis (ABPA), amiodarone-induced pneumonitis (AIP), chronic eosinophilic pneumonia (CEP), and Churg-Strauss syndrome (CSS).
- CEP and CSS exhibited significantly high eosinophil levels (>4%) in BAL, correlating with blood eosinophilia, defining 'eosinophilic alveolitis'.
- IPF, AIP, and ABPA showed lower eosinophil increases, accompanied by neutrophils or lymphocytes, indicating 'mixed alveolitis'.
Conclusions:
- The term 'eosinophilic alveolitis' should be reserved for conditions like CEP and CSS.
- Distinguishing eosinophilic alveolitis from mixed patterns is crucial for accurate diagnosis and management of ILDs.