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Pulmonary eosinophilic infiltrate


Pulmonary eosinophilic infiltrate (pulmonary eosinophilia, eosinophilic pneumonia) includes big group of zaboyolevaniye which main manifestations are the shadings vyyavlenyony radiological in lungs which are followed by an eosinophilia. In the etiological relation distinguish eozi-the nofilny infiltrates connected with:
1) parasitic, invaziyoy;
2) medicines and other chemicals;
3) bronchial asthma;
4) system porazheniyayom of connecting fabric [Mayak R "Soldona M. - In book: Fish-man A., 1980].

The pulmonary aozinofiljny infiltrates of a parasitic proisyokhozhdeniye connected with an invasion of ascarids, ankylostomas, pork иепня and a hepatic fluke, sometimes call a simple legochyony eosinophilia [Crafton J., Duglas A., 1974], or Leffler's (W. Lцf fier) syndrome.

Symptoms of Pulmonary eosinophilic infiltrate:

At most of patients the pulmonary eosinophilic infiltrate connected with an ascaridosis and other helminthic inyovaziya proceeds asymptomatically and comes to light at profilakyotichesky fluorographic researches. Temperature of a teyol, as a rule, normal, sometimes it increases to sub - febrnlny figures with normalization within several days. At some patients emergence of a pulmonary eosinophilic inyofiltrat is followed by an indisposition, a headache, nochyony sweats, cough without phlegm or with an insignificant koliyochestvo of the phlegm painted in yellow color.

At a physical research neyobolshy shortening of percussion tone and wet rattles over the site of infiltrate in lungs can be revealed. All simpyotoma and physical signs stated above quickly, during 1-2 weeks, isyochezat.

Clinical manifestations arise on average in 2 hours — 10 days after the beginning of reception of medicines and are characterized by the following symptoms:
•  dry cough;
•  thorax pain;
•  asthma;
•  fervescence with a fever;
•  arterial hypotonia;
•  small tortoiseshell;
•  arthralgias.

Легочный эозинофильный инфильтрат на рентгенограмме

Pulmonary eosinophilic infiltrate on the roentgenogram

Reasons of Pulmonary eosinophilic infiltrate:

The pathogeny of these changes is studied insufficiently. There is an idea of the leading role of a sensitization and an allergy, vozyonikayushchy at a helminthic invasion. One of proofs of this point of view is increase in content in serum of a kroyova of sick IgE.

Pathoanatomical changes consist in emergence in legyoky the infiltration centers which at a microscopic issleyodovaniye represent alveolar exudation with bolyyoshy quantity of eosinophils. In some cases наблюда­лись perivascular infiltration by leukocytes and small fibrinferments.

Treatment of Pulmonary eosinophilic infiltrate:

Antifilyarialny drug диэгилкарбамазин is most effective. At some patients perhaps sponyotanny recovery, however at patients to whom not проводи­лось special treatment, the disease can proceed dliyotelno - months and years, with repeated aggravations, leading to development of a pneumosclerosis.

Pulmonary eosinophilic infiltrates can arise from influence of drugs and chemical compounds. The legochyony eosinophilic infiltrates developing under the influence of a furadoiin, acetylsalicylic acid, Azathioprinum, chlorine - a propamida, a hromoglikata, an isoniazid, a methotrexate, a penitsilyolin, streptomycin, streptocides, beryllium, salts of a zoloyot and nickel and other connections are described. Besides, eosinophilic pulmonary infiltrates can appear after inhalation pylyyoets of some plants.

The clinical picture of the pulmonary eosinophilic infiltrayot arising after use of a furadonin is described osoyobenno in detail. Reactions of lungs to reception of a furadonin happen acute and chronic. At acute option of reaction through the 2nd p-10 of days after the beginning of reception of a furadonin fever, dry cough, cold, an asthma developed. On roentgenograms diffusion an izmeneyoniya in lungs, sometimes focal inyofiltrata of irregular shape in lungs usually come to light, there were no bystry disappearance and migration of infiltrates, typical for Leffler's sindroyom, vypotny pleurisy sometimes develops, and pleural liquid contains many eosinophils. The uveliyochenny maintenance of eosinophils in blood is characteristic. At the ostyory course of a disease soon after drug withdrawal ischeyozat eosinophilic infiltrate in a lung. At a chronic teyocheniye of a disease the rassasyvaniye of a pulmonary eosinophilic inyofiltrat drags on, and in some cases on its place the pneumosclerosis develops.

Treatment. Acute reactions on medicines and chemical agents of special therapy do not demand, and the termination a deystyoviya, the factor which caused pulmonary infiltrate, leads to fake disappearance of symptoms of a disease. In some cases at the long course of a disease reception glyukokor-tikosteroidny drugs is required.

Pulmonary eosinophilic infiltrates at patients with bronkhiyoalny asthma in half of cases connect with impact on the patient of Aspergillus fumigatus. In certain cases eozinoyofilny infiltrates are caused by inhalation of pollen of plants, house dust, dandruff of animals. Dryness of air which causes a vysuyoshivaniye of a mucous membrane of a respiratory organs, formation of guyosty slime in bronchial tubes and disturbance of mucifying promotes a vozniknoveyoniya of this state. Changes arise at patients with bronchial asthma more often 40 years are more senior and it is preferential at women.

At a morphological research the uchastyok of lungs filled with the exudate containing a big koyolichestvo of eosinophils which are present also at a gleam of bronchial tubes are found and sometimes infiltrirut their walls.

The clinical picture at a considerable part of patients harakyoterizutsya by the heavy course of bronchial asthma. The exacerbation of a disease is followed by temperature increase of t е - l and, sometimes to high figures. A characteristic symptom is cough which happens in pristupoobrazny N сопровождает­ся otkhozhdeniy a dense phlegm in the form of traffic jams and slepyok of bronchial tubes [Mayak R., Soldona M. - In book: Fishman A., 1980].

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