Eosinophilic Pneumonia

What is Eosinophilic Pneumonia?

An eosinophil is a type of inflammatory cell found in blood and different parts of the body. Eosinophilic pneumonia (EP) happens when lots of eosinophils move into the lungs. They can cause injury in the lungs. Sometimes this is because the body has too many eosinophils (high levels in the blood). Sometimes it happens when the eosinophils just go to the wrong places in the body.

EP is a rare diagnosis in children. They can have trouble breathing, cough, and fever. They may have low oxygen levels and could have “crackles” on lung exam. It can happen at any age. Some children can get worse quickly (acute EP). Other children can get worse slowly over months or years (chronic EP).

EP can be caused by:

• Certain medicines (drug-induced)
• Infection by some parasites
• Some types of autoimmune diseases
• Smoking or breathing in toxins

If there is no known cause, it is called idiopathic EP.

Diagnosis

EP is possible when children have breathing trouble and pneumonias that don’t get better with antibiotics. Several tests may need to be done. These include:

• A complete blood count (CBC) might show high levels of eosinophils.
• A chest x-ray will show areas of pneumonia.
• A lung scan (chest CT) may show many areas of pneumonia. These areas of pneumonia can shift and change over time.
• Pulmonary function tests can show signs of airway obstruction (blockage). They can also show signs of restriction (lung stiffness) and trouble moving oxygen (abnormal diffusion).
• A lung scope (bronchoscopy) can show normal airways but high levels of eosinophils.
• A lung biopsy is sometimes needed for the right diagnosis. This will show many eosinophils causing lung injury.

Treatment

Treatment of EP involves medicines and support of breathing. Children may need oxygen to help keep their oxygen levels normal. They may need positive pressure to help them breathe oxygen in and carbon dioxide out. Children who are very sick with acute EP may need to be in the intensive care unit for help breathing.

Medicines are used to block the inflammation in the lung. The most commonly used medicines are steroids. These can be given by mouth or by IV. Children with EP usually need a lot of medicine in the beginning to stop the inflammation. Then medicines can be lowered over time. Newer types of medicines (called biologics) can be used to fight inflammation in different ways. These can help lower the amount of steroids needed.

Your medical team will help decide which medicines to use and how long to use them.

What Does Eosinophilic Pneumonia Mean for My Child?

Most children with EP get better quickly with treatment. They usually go back to not needing any help breathing. In some cases, EP can come back and need repeat treatments. Some children with chronic EP need to be on medicines for a longer time.

It is important to protect your child’s lungs from infection by making sure they get the recommended vaccines.

What to Watch Out For

• If your child is working hard to breathe, talk to a health care provider. If possible, ask to see a lung specialist who is experienced with these conditions.
• Try to prevent infections from common childhood illnesses. Wash your hands often and ask your friends and family to let you know if they are sick before they are around your child.
• Get your child’s vaccines and yearly flu shot.

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This information is for educational purposes only. It should not be used as a substitute for the medical advice of one’s healthcare provider.