Acute eosinophilic pneumonia leading to acute respiratory failure in a current systemic corticosteroid user

Case Report  Open Access

|    Allergy Asthma Immunol Res. 2013 Jul;5(4):242-244. English. Published online 2013 April 05.  http://dx.doi.org/10.4168/aair.2013.5.4.242  Copyright © 2013 The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease Acute Eosinophilic Pneumonia Leading to Acute Respiratory Failure in a Current Systemic Corticosteroid User Hwa Yong Shin,1 Ju Won Choe,2 Minsuk Kwon,3 Ju Young Jang,3 Jae Woo Jung,3 Jae Chol Choi,3 Jong Wook Shin,3 In Won Park,3 Byoung Whui Choi,3 and Jae Yeol Kim3 1Department of Anesthesiology & Pain Medicine, Chung-Ang University College of Medicine, Seoul, Korea. 2Department of Chest Surgery, Chung-Ang University College of Medicine, Seoul, Korea. 3Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea. Correspondence to: Jae Yeol Kim, MD, PhD, Department of Internal Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul 156-755, Korea. Tel: +82-2-6299-1396, Fax: +82-2-825-7571, Email: jykimmd@cau.ac.kr Received August 20, 2012; Revised October 11, 2012; Accepted November 06, 2012. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract A 69-year-old female patient visited the emergency room with fever (38.3℃) and dyspnea. She had been taking prednisolone (5 mg once per day) and methotrexate (2.5 mg once per week) for rheumatoid arthritis for 2 years. Chest computed tomography (CT) showed bilateral, multifocal ground glass opacity with interlobular septal thickening. Peripheral blood leukocyte count was 6,520/mm3 (neutrophils, 77.4%; eosinophils, 12.1%). During the night, mechanical ventilation was initiated due to the development of severe hypoxemia. Bronchoalveolar lavage fluid showed a high proportion of eosinophils (49%). Her symptoms improved dramatically after commencement of intravenous methylprednisolone therapy. This is the first report of idiopathic acute eosinophilic pneumonia developing in a current user of systemic corticosteroids. Keywords: Acute eosinophilic pneumonia, respiratory failure, corticosteroid.