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Hypereosinophilic obliterative bronchiolitis: a distinct, unrecognised syndrome.
MedLine Citation:
PMID:  23258778     Owner:  NLM     Status:  Publisher    
Background: Only isolated biopsy-proven cases of eosinophilic bronchiolitis have been reported, all from Japan.Methods: We present 6 patients with hypereosinophilic obliterative bronchiolitis (HOB), defined by the following criteria: 1-blood eosinophil cell count>1 G·L(-1) and/or BAL eosinophil count>25%, 2-persistent airflow obstruction despite high-dose inhaled bronchodilators and corticosteroids, 3-eosinophilic bronchiolitis at lung biopsy (n=2) and/or direct signs of bronchiolitis (centrilobular nodules, branching opacities) on computed tomography (n=6).Results: Chronic dyspnoea and cough often severe, without the characteristic features of asthma, were the main clinical manifestations. Atopy and asthma were present in the history of 3 and 2 patients, respectively. One patient met biological criteria of the lymphoid variant of idiopathic hypereosinophilic syndrome. Mean blood eosinophil cell count was 2.7 G·L(-1) and mean eosinophil differential percentage at bronchoalveolar lavage was 63%. Mean initial FEV1/FVC ratio was 50%, normalising with oral corticosteroid therapy in all patients. HOB manifestations recurred when oral prednisone was decreased to 10-20 mg·day(-1), but higher doses controlled the disease.Conclusion: HOB is a characteristic entity deserving to be individualised among the eosinophilic respiratory disorders. Thorough analysis is needed to determine whether unrecognised and/or smouldering HOB may further be a cause of irreversible airflow obstruction in chronic eosinophilic respiratory diseases.
J F Cordier; V Cottin; C Khouatra; D Revel; C Proust; N Freymond; F Thivolet-Béjui; J C Glérant
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-20
Journal Detail:
Title:  The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology     Volume:  -     ISSN:  1399-3003     ISO Abbreviation:  Eur. Respir. J.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Hospices Civils de Lyon, Louis Pradel University Hospital, National Reference Centre for Rare Pulmonary Diseases; Université de Lyon, Université Claude Bernard Lyon I, INRA, UMR754, IFR 128, Lyon, France.
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