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Author Spotlight: Investigating the Pathophysiology of Eosinophilic Esophagitis
Published on: May 10, 2024
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Sulfa-induced acute eosinophilic pneumonia
Faria Nasim1, Jose Antony Paul1, Jennifer Boland-Froemming2
1Division of Pulmonary and Critical Care Medicine, University of Maryland, Baltimore, MD, USA.
Respiratory Medicine Case Reports
|September 2, 2021
Summary
Severe acute eosinophilic pneumonia (AEP) linked to sulfa drugs like sulfamethoxazole and sulfasalazine was observed in adolescents. This drug-induced lung injury required intensive care, with some patients needing lung transplants.
Area of Science:
- Pulmonology
- Toxicology
- Pharmacology
Background:
- Acute eosinophilic pneumonia (AEP) is a rare interstitial lung disease.
- Medication-induced lung injury is an important differential diagnosis for AEP.
Observation:
- Three adolescent cases of severe AEP secondary to sulfa medications (sulfamethoxazole, sulfasalazine) are presented.
- Patients exhibited fever, bilateral pulmonary infiltrates, and peripheral eosinophilia after 1-3 weeks of sulfa drug use.
- Steroid treatment was ineffective in all cases.
Findings:
- Histopathology revealed acute and organizing diffuse alveolar damage with eosinophilic infiltration in lung biopsies and explants.
- One patient required extracorporeal membrane oxygenation and prolonged mechanical ventilation.
- Two patients underwent successful lung transplantation.
Implications:
- This series highlights the clinical features of sulfa-induced AEP in adolescents.
- Early recognition and cessation of the offending sulfa medication are crucial.
- Severe cases may necessitate advanced respiratory support and lung transplantation.
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