Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Chronic Eosinophilic Pneumonia (Carrington's) With Increased Serum IgE Levels: A Distinct Subset?

Chronic Eosinophilic Pneumonia (Carrington's) With Increased Serum IgE Levels: A Distinct Subset? Abstract • We report our second case of chronic eosinophilic pneumonia (CEP) (Carrington's pneumonia) with elevated serum IgE values and present a review of the literature on this subject. Our present patient, a 55-year-old woman, had classic symptoms of dry cough, weight loss, malaise, dyspnea, night sweats, and fevers. Significant peripheral blood eosinophilia and a right upper lobe infiltrate were present. Glucocorticoid therapy caused prompt resolution of symptoms, as well as disappearance of blood eosinophilia, elevated serum IgE levels, and pulmonary shadowing. The diagnosis of CEP should not be neglected in the classification of the eosinophilic pneumonias with increased serum IgE levels. The increased serum IgE levels, when present in CEP, seem nonspecific and thus may not be useful as a diagnostic adjunct. However, measurement of IgE may be helpful in CEP, as it has been in allergic bronchopulmonary aspergillosis, to guide the dosage and duration of corticosteroid therapy. (Arch Intern Med 1988;148:2622-2624) References 1. Liebow AA, Carrington CB: The eosinophilic pneumonias. Medicine 1969;48:251-285.Crossref 2. Reeder WH, Goodrich BE: Pulmonary infiltration with eosinophilia (PIE syndrome). Ann Intern Med 1952;36:1217-1240.Crossref 3. Gonzalez EB, Swedo JL, Rajaraman S, et al: Ultrastructural and immunohistochemical evidence for release of eosinophilic granules in vivo: Cytotoxic potential in chronic eosinophilic pneumonia. J Allergy Clin Immunol 1987;79:755-762.Crossref 4. McEvoy JDS, Donald KJ, Edwards RL: Immunoglobulin levels and electron microscopy in eosinophilic pneumonia. Am J Med 1978;64:529-536.Crossref 5. Prin L, Capron M, Gosset P, et al: Eosinophilic lung diseases. Clin Exp Immunol 1986;63:249-257. 6. Carrington CB, Addington WW, Goff AM, et al: Chronic eosinophilic pneumonia. N Engl J Med 1969;280:787-798.Crossref 7. Ricketti AJ, Greenberger PA, Patterson R: Serum IgE as an aid in management of allergic bronchopulmonary aspergillosis. J Allergy Clin Immunol 1984;74:68-71.Crossref 8. Crofton JW, Livingstone JL, Oswald NC, et al: Pulmonary eosinophilia. Thorax 1952;7:1-35.Crossref 9. Schatz M, Wasserman S, Patterson R: Eosinophils and immunologic lung disease. Med Clin North Am 1981;65:1055-1071. 10. Pearson DJ, Rosenow EC III: Chronic eosinophilic pneumonia (Carrington's): A follow-up study. Mayo Clin Proc 1978;53:73-78. 11. Plans Bolivar C, Morell Brotad F, Morera Prat J, et al: Neumonía eosinófila crónica: Estudio de ocho casos. Med Clin 1980;77:8-17. 12. Turner-Warwick M, Assem ESK, Lockwood M: Cryptogenic pulmonary eosinophilia. Clin Allergy 1976;6:135-145.Crossref 13. Gleich GJ, Loegering DA: Immunobiology of eosinophils. Annu Rev Immunol 1984;2:429-459.Crossref 14. Frigas E, Loegering DA, Solley GO, et al: Elevated levels of the eosinophil granule major basic protein in the serum of patients with bronchial asthma. Mayo Clin Proc 1981;56:345-353. 15. Ayars GH, Altman LC, Gleich GJ, et al: Eosinophil and eosinophil granule—mediated pneumocyte injury. J Allergy Clin Immunol 1985;76:595-604.Crossref 16. Weller PF, Lee CW, Foster DW, et al: Generation and metabolism of 5-lipoxygenase pathway leukotrienes by human eosinophils: Predominant production of leukotriene C4. Proc Natl Acad Sci USA 1983;80:7626-7630.Crossref 17. Capron M, Capron A, Dessaint JP, et al: Fc receptors for IgE on human and rat eosinophils. J Immunol 1981;126:2087-2092. 18. Okuda M, Takenaka T, Kawabori S, et al: Ultrastructural study of the specific granules of human eosinophils: Second report: Granule lysis , in Yoshida T, Torisu M (eds): Immunobiology of the Eosinophils . New York, Elsevier Science Publishing Co Inc, 1981, pp 201-210. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Chronic Eosinophilic Pneumonia (Carrington's) With Increased Serum IgE Levels: A Distinct Subset?

Loading next page...
 
/lp/american-medical-association/chronic-eosinophilic-pneumonia-carrington-s-with-increased-serum-ige-2C0uSLMVAh

References (23)

Publisher
American Medical Association
Copyright
Copyright © 1988 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1988.00380120080016
Publisher site
See Article on Publisher Site

Abstract

Abstract • We report our second case of chronic eosinophilic pneumonia (CEP) (Carrington's pneumonia) with elevated serum IgE values and present a review of the literature on this subject. Our present patient, a 55-year-old woman, had classic symptoms of dry cough, weight loss, malaise, dyspnea, night sweats, and fevers. Significant peripheral blood eosinophilia and a right upper lobe infiltrate were present. Glucocorticoid therapy caused prompt resolution of symptoms, as well as disappearance of blood eosinophilia, elevated serum IgE levels, and pulmonary shadowing. The diagnosis of CEP should not be neglected in the classification of the eosinophilic pneumonias with increased serum IgE levels. The increased serum IgE levels, when present in CEP, seem nonspecific and thus may not be useful as a diagnostic adjunct. However, measurement of IgE may be helpful in CEP, as it has been in allergic bronchopulmonary aspergillosis, to guide the dosage and duration of corticosteroid therapy. (Arch Intern Med 1988;148:2622-2624) References 1. Liebow AA, Carrington CB: The eosinophilic pneumonias. Medicine 1969;48:251-285.Crossref 2. Reeder WH, Goodrich BE: Pulmonary infiltration with eosinophilia (PIE syndrome). Ann Intern Med 1952;36:1217-1240.Crossref 3. Gonzalez EB, Swedo JL, Rajaraman S, et al: Ultrastructural and immunohistochemical evidence for release of eosinophilic granules in vivo: Cytotoxic potential in chronic eosinophilic pneumonia. J Allergy Clin Immunol 1987;79:755-762.Crossref 4. McEvoy JDS, Donald KJ, Edwards RL: Immunoglobulin levels and electron microscopy in eosinophilic pneumonia. Am J Med 1978;64:529-536.Crossref 5. Prin L, Capron M, Gosset P, et al: Eosinophilic lung diseases. Clin Exp Immunol 1986;63:249-257. 6. Carrington CB, Addington WW, Goff AM, et al: Chronic eosinophilic pneumonia. N Engl J Med 1969;280:787-798.Crossref 7. Ricketti AJ, Greenberger PA, Patterson R: Serum IgE as an aid in management of allergic bronchopulmonary aspergillosis. J Allergy Clin Immunol 1984;74:68-71.Crossref 8. Crofton JW, Livingstone JL, Oswald NC, et al: Pulmonary eosinophilia. Thorax 1952;7:1-35.Crossref 9. Schatz M, Wasserman S, Patterson R: Eosinophils and immunologic lung disease. Med Clin North Am 1981;65:1055-1071. 10. Pearson DJ, Rosenow EC III: Chronic eosinophilic pneumonia (Carrington's): A follow-up study. Mayo Clin Proc 1978;53:73-78. 11. Plans Bolivar C, Morell Brotad F, Morera Prat J, et al: Neumonía eosinófila crónica: Estudio de ocho casos. Med Clin 1980;77:8-17. 12. Turner-Warwick M, Assem ESK, Lockwood M: Cryptogenic pulmonary eosinophilia. Clin Allergy 1976;6:135-145.Crossref 13. Gleich GJ, Loegering DA: Immunobiology of eosinophils. Annu Rev Immunol 1984;2:429-459.Crossref 14. Frigas E, Loegering DA, Solley GO, et al: Elevated levels of the eosinophil granule major basic protein in the serum of patients with bronchial asthma. Mayo Clin Proc 1981;56:345-353. 15. Ayars GH, Altman LC, Gleich GJ, et al: Eosinophil and eosinophil granule—mediated pneumocyte injury. J Allergy Clin Immunol 1985;76:595-604.Crossref 16. Weller PF, Lee CW, Foster DW, et al: Generation and metabolism of 5-lipoxygenase pathway leukotrienes by human eosinophils: Predominant production of leukotriene C4. Proc Natl Acad Sci USA 1983;80:7626-7630.Crossref 17. Capron M, Capron A, Dessaint JP, et al: Fc receptors for IgE on human and rat eosinophils. J Immunol 1981;126:2087-2092. 18. Okuda M, Takenaka T, Kawabori S, et al: Ultrastructural study of the specific granules of human eosinophils: Second report: Granule lysis , in Yoshida T, Torisu M (eds): Immunobiology of the Eosinophils . New York, Elsevier Science Publishing Co Inc, 1981, pp 201-210.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Dec 1, 1988

There are no references for this article.