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Tropical pulmonary eosinophilia--a review
Jai B Mullerpattan1, Zarir F Udwadia, Farokh E Udwadia
1Department of Respiratory Medicine, P.D. Hinduja National Hospital & MRC, Mumbai, India.
The Indian Journal of Medical Research
|October 19, 2013
Summary
Tropical pulmonary eosinophilia (TPE) is an allergic lung disease caused by filarial parasites. Early diagnosis and treatment with diethylcarbamazine are crucial to prevent long-term respiratory damage.
Area of Science:
- Medical Research
- Tropical Medicine
- Pulmonology
Background:
- Tropical pulmonary eosinophilia (TPE) is a wheezing, fever, and eosinophilia syndrome prevalent in tropical regions.
- It is strongly linked to Wuchereria bancrofti and Brugia malayi infections.
- Pathogenesis involves an exaggerated immune response to filarial antigens, with eosinophils playing a key role.
Purpose of the Study:
- To review the established knowledge on Tropical Pulmonary Eosinophilia (TPE).
- To highlight the diagnostic features, pathogenesis, and clinical implications of TPE.
- To discuss current treatment strategies and the need for better diagnostic markers.
Main Methods:
- Review of existing literature on Tropical Pulmonary Eosinophilia.
- Analysis of clinical presentation, immunological findings, and pathological changes.
- Evaluation of treatment outcomes and pulmonary function test results.
Main Results:
- TPE is characterized by striking peripheral blood eosinophilia (>3000/μl) and elevated IgE levels.
- Pulmonary function tests can reveal restrictive and obstructive abnormalities, with reduced diffusion capacity.
- Untreated TPE can lead to significant respiratory morbidity, and relapses occur in approximately 20% of patients despite diethylcarbamazine (DEC) treatment.
Conclusions:
- Diethylcarbamazine (DEC) is the primary treatment for TPE, but relapses necessitate further management considerations.
- Steroids show promise, but randomized controlled trials are needed to confirm optimal dosage and duration.
- A specific and accessible diagnostic marker is essential to differentiate TPE from other causes of pulmonary eosinophilia.
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