Pulmonary Eosinophilia, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

This book describes Pulmonary Eosinophilia, Diagnosis and Treatment and Related Diseases

Eosinophilia may not seem a dangerous illness when it is present as the only cause of the medical illness that happened to my middle aged patient 2 weeks ago.

After about 50 years free from asthma and severe allergic rhinitis, he had a severe attack of asthma and rhinitis for almost 2 months before he consulted me.

Even with medication from other general practitioners, he was so breathless that he was unable to sleep at night.
Most nights he sat on the floor gasping for breath while using hundreds of paper tissues to dry his dripping nose.

Antihistamines and bronchodilators had little effect on him.

He eventually fell asleep sitting down with blankets covering him and hanging on to the side of the beds.
Only when mornings come did he feel better although he was still breathless and his nose still dripped.

He was taken to the doctor every morning for an injection of aminophylline and antihistamine which reduced his symptoms partially.

In the end when he saw me he had lost 2 kgs of weight and was so exhausted that he can hardly keep his eyes open.

I decided to start him on corticosteroids which appeared to reduce his symptoms especially at night.

Eventually I forced him to take a chest X-rays and complete blood tests including tumor markers to exclude any possible cancer.

His chest x-rays and blood tests were normal but his eosinophils were particularly high >5,000 eosinophils/microL.

Stool tests for ova and blood were normal and more likely eliminate any parasitic disease.

Eosinophils are particularly high in allergic conditions and in parasitic infections.

I had his air conditioners cleaned to exclude any dust or mites that may cause him any allergy.

He was also told to avoid any herbs or Chinese medicines.

He was also told to use ventolin (reliever) and steroid (preventer) inhalers.

He had since then improved and his steroid tablets dosage had been reduced.

Much has been mentioned about bacterial infection being an important cause of death in the human person and less on allergy causes of lung diseases such as asthma, chronic lung disease, and pulmonary fibrosis being a large cause of death in humans.

Pulmonary eosinophilia is the infiltration of eosinophils into the lung compartments comprising airways, interstitium, and alveoli.

Higher quantities of eosinophils in the lungs have been linked with:
1. Different infections,
2. Drugs,
3. Parasites,
4. Autoimmune processes,
5. Malignancies and
6. Obstructive lung diseases.

Fungal infections and parasitic infestations are often causes of pulmonary infections in immunocompromised patients that can end in deaths more often than bacterial pnuemonias.

Many people may not realize it but asthma, fungal pneumonia are a main source of dangerous lung diseases.

Pulmonary eosinophilia may be broadly categorized into:
1. Primary/idiopathic and
2. Secondary/extrinsic from external factors

Most incidents of this disorder are due to an allergic reaction from:
1. A medicine, such as a sulfonamide antibiotic or a non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen or naproxen
2. Infection with a fungus such as Aspergillus fumigatus or Pneumocystis jirovecii
3. A parasite, such as the roundworms Ascariasis lumbricoides, or Necator americanus, or the hookworm Ancylostoma duodenale

In some cases, no cause is evident and the disease is called Primary pulmonary eosinophilia.

The treatment of PE is dependent on the underlying cause and is directed towards the relief of the underlying cause.

Oxygen and corticosteroids are the main treatment of Pulmonary Eosinophilia.

TABLE OF CONTENT
Introduction
Chapter 1 Pulmonary Eosinophilia
Chapter 2 Causes
Chapter 3 Symptoms
Chapter

• Language: English
• Publisher: Kenneth Kee
• Release date: Dec 18, 2019
• ISBN: 9780463736227

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Pulmonary Eosinophilia,

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2019 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Pulmonary Eosinophilia, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Pulmonary Eosinophilia)

This e-Book is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.

This autobiography account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Pulmonary eosinophilia

What is Pulmonary eosinophilia?

Pulmonary eosinophilia (PE) is the inflammation of the lungs from a rise in eosinophils, a type of white blood cell.

Pulmonary eosinophilia is depicted as infiltration of eosinophils into the lung compartments comprising airways, interstitium, and alveoli.

Higher quantities of eosinophils in the lungs have been linked with:

1. Different infections,

2. Drugs,

3. Parasites,

4. Autoimmune processes,

5. Malignancies and

6. Obstructive lung diseases.

What are the causes of Pulmonary eosinophilia?

Causes

The finding of pulmonary eosinophilia is not definite for a particular disease.

Pulmonary eosinophilia may be broadly categorized into:

1. Primary/idiopathic and

2. Secondary/extrinsic from external factors

Most incidents of this disorder are due to an allergic reaction from:

1. A medicine, such as a sulfonamide antibiotic or a non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen or naproxen

2. Infection with a fungus such as Aspergillus fumigatus or Pneumocystis jirovecii

3. A parasite, such as the roundworms Ascariasis lumbricoides, or Necator americanus, or the hookworm Ancylostoma duodenale

In some cases, no cause is evident.

Primary pulmonary eosinophilia (EP) happens due to unknown causes, such as:

1. Acute eosinophilic pneumonia (AEP),

2. Chronic eosinophilic pneumonia (CEP),

3. Eosinophilic granulomatosis with polyangiitis (EGPA), and

4. Hyper-eosinophilic syndrome (HES).

Secondary pulmonary eosinophilia happens due to known causes, such as:

1. Allergic broncho-pulmonary aspergillosis (ABPA),

2. Parasites,

3. Medicines,

4. Radiation effects, and

5. Malignancies.

Mildly raised levels of eosinophils may be evident in the bronchoalveolar lavage (BAL) differential cell count in the idiopathic interstitial pneumonia, sarcoidosis, and Langerhans cell histiocytosis.

In these diseases, they are just a linkage and do have no causative effects.

All drugs taken in the weeks or months before the syndrome of eosinophilic pneumonia (EP) must be comprehensively investigated, such as illicit drugs.

Medicines that are often identified to cause drug-induced EP are non-steroidal anti-inflammatory drugs, antibiotics such as trimethoprim-sulfamethoxazole, penicillins, nitrofurantoin and minocycline, angiotensin converting enzyme-inhibitors, sulfa drugs, and ethambutol.

Parasitic infestation is the most frequent cause of eosinophilia throughout the world.

Simple pulmonary eosinophilia, also called Loeffler syndrome, indicates the acute, transient pulmonary radiographic opacities and peripheral blood eosinophilia linked with intestinal parasites, often present with Ascaris and Strongyloides infestations.

Incidence

The true incidence of AEP is infrequent.

It is much more frequent in men.

CEP is also a rare disorder, forming less than 2.5% of ILD cases documented.

It is more frequent in women, who are involved two times that of men with the majority of them non-smokers.

The incidence of EGPA is also not known among the ANCA linked vasculitis; it is the least frequent.

Pathophysiology

Eosinophils are one of the main white blood cells that happen due to allergic inflammation.

They form from hematopoietic stem cells and go through maturation and activation by the IL-5