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Distinct clinical phenotypes and outcomes in pediatric chronic eosinophilic pneumonia: a 12- year retrospective

Changchang Li1, Lili Zhu1, Gang Yu1

  • 1Department of Children's Respiratory Disease, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 West Xueyuan Road, Lucheng District, Wenzhou , 325027, People's Republic of China.

European Journal of Pediatrics
|June 19, 2026
PubMed

Insights

Pediatric chronic eosinophilic pneumonia (CEP) is linked to allergies and often presents with cough and wheezing. Younger children with more severe lung involvement and lower initial steroid doses may have prolonged disease courses.

Area of Science:

  • Pediatric Pulmonology
  • Rare Diseases
  • Interstitial Lung Disease

Background:

  • Chronic eosinophilic pneumonia (CEP) is a rare interstitial lung disease primarily characterized in adults, often linked to asthma or allergies.
  • Diagnosis of CEP relies on identifying pulmonary eosinophilia, with systemic corticosteroid therapy as the established treatment.
  • Limited data exists for pediatric CEP, leading to diagnostic and management challenges.

Purpose of the Study:

  • To analyze demographic, clinical, laboratory, imaging, bronchoalveolar lavage fluid (BALF), and treatment data in children diagnosed with CEP.
  • To compare characteristics and outcomes between children with 'Cured' and 'Protracted' CEP phenotypes.
  • To identify factors associated with a protracted disease course in pediatric CEP.

Main Methods:

  • Retrospective cohort study of pediatric patients with CEP between 2014 and 2025.
  • Data collected included patient demographics, clinical symptoms, laboratory results, chest CT imaging, BALF analysis, and treatment details.
  • Patients were categorized into 'Cured' and 'Protracted' groups based on symptom and imaging resolution over 3 months.

Main Results:

  • Thirteen pediatric patients (median age 2.92 years, 61.5% male) with CEP were identified, 84.6% had allergic comorbidities.
  • Common symptoms included productive cough (92.3%) and wheeze (61.5%); chest CT showed interlobular septal thickening and ground-glass opacities (92.3%).
  • Marked eosinophilia (median 46%) was observed in BALF. 61.5% achieved cure, while 38.5% had a protracted course, associated with younger age, extensive radiographic involvement, and lower initial corticosteroid exposure.

Conclusions:

  • Pediatric CEP is strongly associated with atopy and can present with early onset and male predominance.
  • A protracted CEP phenotype in children may be linked to younger age, extensive radiographic findings, specific biomarker profiles (elevated platelets, lower acute-phase reactants), and less initial corticosteroid therapy.
  • Early diagnosis and adequate initial corticosteroid treatment are critical for improving outcomes in pediatric chronic eosinophilic pneumonia.

Keywords:
BiomarkersChronic eosinophilic pneumoniaPediatricsPhenotypeTherapy

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