Abstract

Objectives: We aim to clarify relapse predictive factors of chronic eosinophilic pneumonia (CEP). 

Subjects and Methods: We extracted 61 consecutive cases of CEP in our institution between 1999 and 2016. 5 cases were excluded because they did not undergo bronchoalveolar lavage (BAL) and/or high-resolution (HR) CT at diagnosis. We retrospectively reviewed 56 cases with CEP, and examined relapse of CEP by December 2017. Relapse was defined as increased dose of corticosteroid or deterioration of radiological findings consistent with CEP during the clinical course after the start of the treatment. We investigated the predictive factors of relapse of CEP by univariate and multivariate Cox proportional hazard regression analysis.

Results: The median (IQR) age at diagnosis was 61.5 (40.3-70.8) years old. There were 25 males and 31 females. 31 patients (55.3%) were never smokers, and 19 patients (33.9%) had asthma. The median (IQR) laboratory findings at diagnosis revealed peripheral blood eosinophilia: 22.8 (10.7-43.7)%, BAL eosinophilia: 28.5 (10.7-65.5)%. 32 patients received corticosteroid therapy. Radiologic findings on HRCT showed centrilobular opacities in 26 patients (46.4%). The relapse of CEP was seen in 20 patients (35.7%) during the observation period (median: 504 days, IQR: 139.8-1171.8 days). The patients with centrilobular opacities show significantly earlier relapse than that without centrilobular opacities (p=0.0224) by univariate analysis. However, the percentages of eosinophils of BAL and peripheral blood, and serum immunoglobulin-E were not significant predictive factors of relapse of CEP. 

Conclusion: Relapse of CEP could be predicted by centrilobular opacities on HRCT at the diagnosis of CEP.