Description, Causes and Risk Factors:
A disease characterized by night sweats, exertional dyspnea
, occasional wheezing, and peripheral eosinophilia. X-rays show peripheral, nonsegmental pulmonary infiltrates that can be nodular with cavitation. Responds to treatment with corticosteroids.
Alternative Name: Chronic eosinophilic pneumonia (CEP).
Chronic eosinophilic pneumonia was first noticed in the year 1969. Prior to that, eosinophilic pneumonia was a well described pathologic entity usually associated with medication or parasite exposures.
Eosinophilic pneumonia (EP) is a disease in which a certain type of white blood cell called an eosinophil accumulates in the lungs. These cells cause disruption of the normal alveoli where oxygen is extracted from the atmosphere.
Eosinophils participate in the immune response of the lung. The number of eosinophils increases during many inflammatory and allergic reactions, including asthma, which frequently accompanies certain types of eosinophilic pneumonia. Eosinophilic pneumonia differs from typical pneumonias in that there is no suggestion that the tiny air sacs of the lungs (alveoli) are infected by bacteria, viruses, or fungi. However, the alveoli and often the airways do fill with eosinophils. Even the blood vessel walls may be invaded by eosinophils, and the narrowed airways may become plugged with an accumulation of secretions (mucus) if asthma develops.
Most causes of eosinophilic pneumonia have similar symptoms. Cough, fever, increasing breathlessness, and night sweats are prominent and almost universal.
Types of Carrington Disease:
Acute eosinophilic pneumonia typically follows a rapid course. Fever and cough may develop only one or two weeks before difficulties breathing progress to the point of respiratory failure requiring mechanical ventilation.
Chronic eosinophilic pneumonia (Carrington Disease) usually follows a slower course. Symptoms accumulate over several months and include fevers, cough, breathlessness, wheezing, and weight loss. Individuals with CEP are often diagnosed with asthma before CEP is finally recognized.
Eosinophilic pneumonia (Carrington Disease) can develop in several different ways depending on the underlying cause of the disease. Eosinophils are thought to play a central role in defending the body against infection by parasites. Many diseases, such as asthma and eczema, are caused when eosinophils overreact to environmental triggers and release an excess of chemicals (cytokines) such as histamine. The common characteristic among different causes of EP is eosinophil overreaction or dysfunction in the lung.
Carrington Disease due to medications or environmental exposures is similar and occurs after an exposure to a known offending agent. EP due to parasitic infections has a similar prodromein addition to a host of different symptoms related to the variety of underlying parasites. EP in the setting of cancer often develops in the context of a known diagnosis of lung cancer, cervical cancer, etc.
Microscopic examination of cells from coughed-up sputum or washings of the alveoli obtained during bronchoscopy typically shows clumps of eosinophils.
Other laboratory tests may be performed to search for an infection with fungi or parasites; these tests may include microscopic examination of stool specimens to look for worms and other parasites.
Carrington Disease may be mild, and people with the disease may get better without treatment. For acute cases, a corticosteroid such as prednisone is usually needed. In chronic eosinophilic pneumonia, prednisone may be needed for many months or even years. If a person develops wheezing, the same treatments used for asthma are given as well. If worms or other parasites are the cause, the person is treated with appropriate drugs. Ordinarily, drugs that may be causing the illness are discontinued.
Because EP affects the lungs, individuals with EP have difficulty breathing. If enough of the lung is involved, it may not be possible for a person to breathe enough to live without support. Non-invasive machines such as a bilevel positive airway pressure (BIPAP) machine may be used. Otherwise, placement of a breathing tube into the mouth may be necessary and a ventilator may be used to help the person breathe.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.