Clinical Characteristics and Factors Influencing the Occurrence of Acute Eosinophilic Pneumonia in Korean Military Personnel

Acute eosinophilic pneumonia (AEP) is an uncommon inflammatory lung disease, and limited data exist concerning the clinical characteristics and factors that influence its occurrence. We retrospectively reviewed the records of AEP patients treated at Korean military hospitals between January 2007 and December 2013. In total, 333 patients were identified; their median age was 22 years, and all were men. All patients presented with acute respiratory symptoms (cough, sputum, dyspnea, or fever) and had elevated levels of inflammatory markers including median values of 13,185/µL for white blood cell count and 9.51 mg/dL for C-reactive protein. All patients showed diffuse ground glass opacity/consolidation, and most had pleural effusion (n = 265; 80%) or interlobular septal thickening (n = 265; 85%) on chest computed tomography. Most patients had normal body mass index (n = 255; 77%), and only 30 (9%) patients had underlying diseases including rhinitis, asthma, or atopic dermatitis. Most patients had recently changed smoking habits (n = 288; 87%) and were Army personnel (n = 297; 89%).The AEP incidence was higher in the Army group compared to the Navy or Air Force group for every year (P = 0.002). Both the number of patients and patients with high illness severity (oxygen requirement, intensive care unit admission, and pneumonia severity score class ≥ III) tended to increase as seasonal temperatures rose. We describe the clinical characteristics of AEP and demonstrate that AEP patients have recently changed smoking habits and work for the Army. There is an increasing tendency in the numbers of patients and those with higher AEP severity with rising seasonal temperatures.

[1]  B. Akkanti,et al.  Acute eosinophilic pneumonia , 2016, BMJ Case Reports.

[2]  Se Jin Kim,et al.  Clinical implications of correlation between peripheral eosinophil count and serum levels of IL-5 and tryptase in acute eosinophilic pneumonia. , 2014, Respiratory medicine.

[3]  Se Jin Kim,et al.  Clinical implications of initial peripheral eosinophilia in acute eosinophilic pneumonia , 2014, Respirology.

[4]  M. Bando,et al.  Clinical significance of interleukin 33 (IL-33) in patients with eosinophilic pneumonia. , 2013, Allergology international : official journal of the Japanese Society of Allergology.

[5]  S. Y. Lim,et al.  Acute eosinophilic pneumonia presenting as life-threatening hypoxaemia necessitating extracorporeal membrane oxygenation. , 2012, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[6]  C. Rhee,et al.  Clinical characteristics and corticosteroid treatment of acute eosinophilic pneumonia , 2012, European Respiratory Journal.

[7]  C. Lee,et al.  Fraction of exhaled nitric oxide in patients with acute eosinophilic pneumonia. , 2012, Chest.

[8]  E. Ono,et al.  Reduced IgG levels found during acute eosinophilic pneumonia, which normalize during recovery from disease. , 2008, Respiratory medicine.

[9]  H. Uchiyama,et al.  Alterations in smoking habits are associated with acute eosinophilic pneumonia. , 2008, Chest.

[10]  Hironobu Nakamura,et al.  Acute eosinophilic pneumonia: Thin-section CT findings in 29 patients. , 2008, European journal of radiology.

[11]  James N. Allen,et al.  Acute Eosinophilic Pneumonia , 2006, Seminars in respiratory and critical care medicine.

[12]  W. Carr,et al.  Acute eosinophilic pneumonia among US Military personnel deployed in or near Iraq. , 2004, JAMA.

[13]  Kenji Matsumoto,et al.  Elevated interleukin‐18 levels in bronchoalveolar lavage fluid of patients with eosinophilic pneumonia , 2004, Allergy.

[14]  Kenji Nakamura,et al.  Cigarette smoking-induced acute eosinophilic pneumonia showing tolerance in broncho-alveolar lavage findings. , 2003, Internal medicine.

[15]  T. Kawayama,et al.  Fatal idiopathic acute eosinophilic pneumonia with acute lung injury , 2002, Respirology.

[16]  C. Guérin,et al.  Idiopathic acute eosinophilic pneumonia: a study of 22 patients. , 2002, American journal of respiratory and critical care medicine.

[17]  Kazuyoshi Watanabe,et al.  Acute eosinophilic pneumonia following cigarette smoking: a case report including cigarette-smoking challenge test. , 2002, Internal medicine.

[18]  Georgeann McGuinness,et al.  Acute eosinophilic pneumonia in a New York City firefighter exposed to World Trade Center dust. , 2002, American journal of respiratory and critical care medicine.

[19]  E. Miyazaki,et al.  Elevated levels of thymus- and activation-regulated chemokine in bronchoalveolar lavage fluid from patients with eosinophilic pneumonia. , 2002, American journal of respiratory and critical care medicine.

[20]  M. Nakajima,et al.  Acute eosinophilic pneumonia following cigarette smoking. , 2000, Internal medicine.

[21]  M. Isobe,et al.  Predominant Implication of IL-5 in Acute Eosinophilic Pneumonia: Comparison with Chronic Eosinophilic Pneumonia , 1998, International Archives of Allergy and Immunology.

[22]  M. Wewers,et al.  Detection of IL-5 and IL-1 receptor antagonist in bronchoalveolar lavage fluid in acute eosinophilic pneumonia. , 1996, The Journal of allergy and clinical immunology.

[23]  M. Taniguchi,et al.  Possible involvement of an environmental agent in the development of acute eosinophilic pneumonia. , 1996, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[24]  M. Taniguchi,et al.  A clinical study of idiopathic eosinophilic pneumonia. , 1994, Chest.

[25]  E. Pacht,et al.  Acute eosinophilic pneumonia as a reversible cause of noninfectious respiratory failure. , 1989, The New England journal of medicine.