Pulmonary infiltrates and eosinophilia revisited
David P. Meeker, MDAddress reprint requests to D.P.M., Department of Pulmonary Disease, Cleveland Clinic Foundation, One Clinic Center, 9500 Euclid Avenue, Cleveland, Ohio 44195.
Diseases characterized by pulmonary infiltrates and peripheral eosinophilia have been grouped based on a common clinical presentation. Early classification schemes viewed these syndromes as a continuum with significant overlap between categories. Although understanding of certain of these syndromes has increased, this classification system remains a useful framework for identification and diagnosis. At present, we cannot predict which patients with isolated lung involvement will progress to involvement of other organs. Early diagnosis and close follow-up are critical. Corticosteroids are the primary treatment in most of these diseases; cytotoxic agents also have a role. The role of the eosinophil in the disease process and the syndromes included in the differential diagnosis are reviewed. Loeffler’s syndrome, eosinophilic pneumonia, the hypereosinophilic syndrome, allergic bronchopulmonary aspergillosis, Churg-Strauss syndrome, and tropical pulmonary eosinophilia are discussed in detail.