Eosinophilic lung disease - chronic

Case contributed by Lawrence Josey
Diagnosis probable


Acute exacerbation of asthma, requiring hospitalization.

Patient Data

Age: 55 years
Gender: Female

HRCT as workup for pulmonary fidings on chest X-ray.

There are bilateral predominantly peripheral patchy regions of ground-glass opacification within the lungs. No subpleural sparing. There is bilateral traction bronchiectasis with bronchial wall thickening in the parahilar regions extending to the lower lobes. No air trapping on the expiratory images (not provided). Cavitary lesions noted.

Mediastinal lymphadenopathy measures up to 1.4 cm in the precarinal region as well as in the anterior mediastinum. Main pulmonary trunk caliber is increased at 32 mm.

Case Discussion

Patient was admitted to respiratory ward. (FEV1: 0.58, 27% - FVC: 0.8L, 35% - DLCO: 8.4, 39%) treated with regular Albuterol nebulisation and physiotherapy. Atypical serology was negative. Sputum M.C.S was negative.

Oral steroids were given (Prednisolone started at 50 mg and weaned to 25 mg). The patient had pulse IV Methylprednison for consecutive three days before discharge. Patient was commenced on Azathioprine 50 mg which she will be maintained on for a period of time with steroids.

Bone scan was performed which confirmed osteoporosis.

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