INHALED CORTICOSTEROIDS IN THE TREATMENT OF CHRONIC EOSINOPHILIC PNEUMONIA

Year 2010, Volume: 4 Issue: 2, 55 - 60, 25.07.2010

Aydın Yılmaz

Abstract

Chronic eosinophilic pneumonia (CEP) is a rare disease which responds favourably to corticosteroid (CS) treatment. However, there is no consensus regarding the initial CS dose and duration of treatment. The major complication is the relapse of the disease upon tapering or discontinuation of CS treatment. The role of inhaled corticosteroids in CEP patients has not been evaluated, although a decreased frequency of relapse has been previously reported in CEP patients with asthma receiving inhaled corticosteroids.
We decided to administer oral plus inhaled CS therapy in seven patients with CEP in whom relapse occurred during long-term follow-up.
Inhaled CS treatment resulted in a reduced need for oral CS without causing an increase in relapse rate or obstructive lung function defect.
By using inhaled and oral CS combination, the lowest dose of oral CS should be determined individually, and a long-term follow up should be planned in relapses.

Keywords

Chronic eosinophilic pneumonia, treatment, inhaled corticosteroids

KRONİK EOZİNOFİLİK PNÖMONİ TEDAVİSİNDE İNHALE KORTİKOSTEROİDLER

Abstract

Kronik eozinofılik pnömoni (KEP) kortikosteroidlere iyi cevap veren nadir görülen bir hastalıktır. Bununla birlikte kortikosteroid (KS) başlangıç dozları ve tedavi süresini belirleyen ortak görüş yoktur. En önemli komplikasyon ks dozu azaltılırken veya kesildiğinde gelişen nükslerdir. KEP ile birlikte astımı olduğu için inhale KS alan hastalarda nüks sıklığının daha az olduğu bildirilmekle birlikte KEP hastalarında inhale KS’lerin rolü belli değildir.
Uzun süreli takipte relaps gelişen 7 KEP hastasına oral KS ile beraber inhale KS verilmesi planlandı.
inhale KS tedavisi nüksleri ve obstrüktif solunum fonksiyon bozukluğunu artırmadan oral KS ihtiyacını azaltmıştır.
Inhale ve oral KS’ler birlikte kullanılarak en düşük oral KS dozu kullanılabilir ve nükslerde uzun dönem izlem planlanmalıdır.

Keywords

Kronik eozinofilik pnömoni, tedavi, inhale kortikosteroidler

References

• 1. Carrington CB, Addington WW, Goff AM, Madoff IM, Marks A, Schwaber JR, et al. Chronic eosinophilic pneumonia. N Engl J Med 1969; 280: 787-798
• 2. Marchand E, Cordier JF. Review Idiopathic chronic eosinophilic pneumonia. Orphanet J Rare Dis 2006; 1: 11
• 3. Marchand E, Reynaud-Gaubert M, Lauque D, Durieu J, Tonnel AB, Cordier JF: Idiopathic chronic eosinophilic pneumonia. A clinical and follow-up study of 62 cases. The Groupe d’Etudes et de Recherche sur les Maladies “Orphelines" Pulmonaires (GERM”O”P). Medicine (Baltimore) 1998; 77: 299-312
• 4. Jederlinic PJ, Sicilian L, Gaensler EA. Chronic eosinophilic pneumonia. A report of 19 cases and a review of the literature. Medicine (Baltimore) 1988, 67: 154-162
• 5. Rao M, Steiner P, Rose JS, Kassner EG, Kottmeier P, Steiner M: Chronic eosinophilic pneumonia in a one-year-old child. Chest 1975; 68: 118-120
• 6. Wubbel C, Fulmer D, Sherman J. Chronic eosinophilic pneumonia: a case report and national survey. Chest 2003; 123:1763-1766
• 7. Naughton M, Fahy J, Fitzgerald MX: Chronic eosinophilic pneumonia. A long-term followup of 12 patients. Chest 1993; 103: 162-165
• 8. Marchand E, Etienne-Mastroianni B, Chanez P, Lauque D, Leclerc P, Cordier JF. The Groupe d’Etudes et de Recherche sur les Maladies “Orphelines” Pulmonaires (GERM”O”P). Idiopathic chronic eosinophilic pneumonia and asthma: how do they influence each other? Eur Respir J 2003; 22: 8-13
• 9. Gaensler EA, Carrington CB: Peripheral opacities in chronic eosinophilic pneumonia: the photographic negative of pulmonary edema. AJR Am J Roentgenol 1977, 128: 1-13
• 10. Pearson DL, Rosenow EC 3rd: Chronic eosinophilic pneumonia (Carrington's): a follow-up study. Mayo Clin Proc 1978; 53: 73-78
• 11. Durieu J, Wallaert B, Tonnel AB and Groupe d’Etude en Pathologie Interstitielle de la Societe de Pathologie Thoracique du Nord. Long-term follow-up of pulmonary function in chronic eosinophilic pneumonia. Eur Respir J 1997; 10(2): 286-291
• 12. Fox B, Seed WA: Chronic eosinophilic pneumonia. Thorax 1980; 35: 570-580
• 13. Gaensler EA, Carrington CB. Peripheral opacities in chronic eosinophilic pneumonia: the photographic negative of pulmonary edema. AJR 1977; 128: 1-13
• 14. Greenberger PA. Allergic bronchopulmonary aspergillosis and fungoses. Clin Chest Med 1988; 9: 599-608
• 15. Alam M, Burki NK. Chronic eosinophilic pneumonia: A review. South Med J 2007; 100(1): 49-53
• 16. Lavandier M, Carre P. Effectiveness of inhaled high-dose corticosteroid therapy in chronic eosinophilic pneumonia. Chest 1994; 105(6): 1913-1914