The Journal of the Japanese Respiratory Society ONLINE JOURNAL
ABSTRACT
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Article in Japanese
Case Report
Acute Eosinophilic Pneumonia with Positive Response to Smoking Challenge Test, Suggesting the Involvement of Health Food
Masanori Nakanishi1) , Seitaro Okamura1) , Yosiki Demura2) , Takeshi Ishizaki3) , Isamu Miyamori2) and Harumi Itoh4)
1)Department of Internal Medicine, National Sanatorium Tsuruga Hospital, Tsuruga, Fukui Prefecture, Japan, 2)Third Department of Internal Medicine, Fukui Medical University, Fukui, Fukui Pref., Japan, 3)Department of Science of Nursing, Fukui Medical University, Fukui, Fukui Pref., Japan, 4)Department of Radiology, Fukui Medical University, Fukui, Fukui Pref., Japan
ABSTRACT
A 17-year-old girl was admitted to our hospital because of acute febrile illness, progressive dyspnea and severe hypoxemia. Chest radiography and HRCT showed bilateral diffuse ground-glass opacities, consolidation, Kerley lines and pleural effusion. Analysis of bronchoalveolar lavage fluid showed 41.9% eosinophils, and a transbronchial lung biopsy revealed infiltration of eosinophils into the alveolar septa and mild alveolar septal edema. The patient's condition was improved immediately by corticosteroid therapy. She had begun smoking and taking health food (chitosan) 3 months before the admission. A smoking challenge test was positive and a drug-induced lymphocyte stimulation test for chitosan was positive. These findings suggested acute eosinophilic pneumonia caused by smoking and health food. The concentration of interleukin-5 (IL-5) in the serum and BALF/granulocyte colony-stimulating factor (G-CSF) in the serum on admission were very high, but decreased after the improvement. Therefore, it is likely that IL-5 and G-CSF are important in the onset of acute eosinophilic pneumonia.
KEYWORDS: Acute eosinophilic pneumonia, Smoking challenge test, Drug lymphocyte stimulation test, IL-5, G-CSF
RECEIVED: 2000.8.2
JJRS, 39(5): 357-358, 2001
