Source: International Congress 2014 – ILDs 6

Abstract

Idiopathic acute eosinophilic pneumonia is a rare disease. It presents with acute febrile illness, respiratory insufficiency, pulmonary infiltration and high eosinophil levels in broncho alveolar lavage fluid. Its pathogenesis is not well understood, but may relate to the exposure to exogenous substances (e.g. cocaine or heroin).A 25 year old female presented to our emergency department with a chief complaint of dyspnea and cough starting two weeks ago. Despite the application of several antibiotics her complaints worsened.Her examination at the time of presentation revealed an oxygen saturation at room air of 88%, and a chest x-ray with bilateral infiltrates. Laboratory analysies demonstrated the following observations: Eosinophil blood count was 37.2% and the sputum eosinophil count was 36.0%.A preliminary diagnosis of eosinophilic pneumonia was made. High-dose steroids (prednisolone 40mg/d) and antibiotic treatment (clarithromycin) was promptly started. There was immediate improvement, oxygen insufflation was reduced and laboratory results returned to normal level (eosinophils in blood 2% and in sputum 3%).An amphetamine drug test in urine was positive. No increase of ANA, pANCA, cANCA or rheumatoid factors were detected.After 4 weeks, complete resolution of symptoms and radiographical abnormalities were noted. Her respiratory function parameters were initially FEV1 1.99 l (64% S) and VC 2.57 l (71% S) and after treatment FEV1 2.92 l (93% S) and VC 3.73 l (103% S).This is the second case report (Whithaus KC and Rutland BM, 2008) suggesting that amphetamine intake might induce the development of lung infiltrates with accompanying peripheral blood eosinophilia and high eosinophil level in sputum.

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Citations should be made in the following way:
K. Rososinska, S. Henschke, M. Reichert, R. Bals (Homburg/Saar, Germany). Amphetamine induced eosinophilic pneumonia: A case report. Eur Respir J 2014; 44: Suppl. 58, 3795

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