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Idiopathic chronic eosinophilic pneumonia and asthma: how do they influence each other?

¹ Centre d'Etudes et de Recherche sur les Maladies "Orphelines" Pulmonaires, Hôpital Cardiovasculaire et Pneumologique Louis Pradel, Université Claude Bernard, Hospices Civils de Lyon, ³ Service de Pneumologie, Hôpital Louis Pradel, Lyon, ⁴ Service de Pneumologie, Hôpital Arnaud de Villeneuve, Montpellier, ⁵ Service de Pneumologie, Centre Hospitalier Purpan, Toulouse, ⁶ Service de Pneumologie, Centre Hospitalier, Sartrouville, France. ² Service de Pneumologie, Cliniques Universitaires UCL de Mont-Godinne, Yvoir, Belgium

CORRESPONDENCE: J.F. Cordier, Hôpital Louis Pradel, BP Lyon-Montchat, 69394, Lyon cedex 03, France. Fax: 33 472357653. E-mail: germop@univ-lyon1.fr

Keywords: asthma, follow-up studies, idiopathic chronic eosinophilic pneumonia, steroids

Received: September 16, 2002
Accepted January 29, 2003

This study was supported by grant HCL-PHRC 93-97.005 from Ministère de l'Emploi et de la Solidarité, Paris, France.

Abstract

Since idiopathic chronic eosinophilic pneumonia (ICEP) and asthma are frequently associated, their possible reciprocal influence on clinical presentation and evolution were investigated.

The clinical and follow-up features of 53 cases of ICEP, of which 41 (77%) had asthma, were reviewed retrospectively. Asthma preceded the diagnosis of ICEP in 26 patients, was contemporaneous in eight patients, and developed 17±12 months after ICEP in seven patients.

Presentation of ICEP was similar in asthmatics and nonasthmatics with the exception of a higher level of total immunoglobulin E in the former group. Patients with asthma at the time of diagnosis of ICEP were more likely to remain free of relapse of ICEP (56 versus 23%) and had a lower number of relapses per year of follow-up (median 0 versus 0.24). Moreover, they were treated more frequently with long-term inhaled corticosteroids (88 versus 31%) at last follow-up. Asthma got worse after the diagnosis of ICEP and frequently required long-term oral corticosteroids.

To conclude, among patients with idiopathic chronic eosinophilic pneumonia, asthmatics have a lower frequency of relapse than nonasthmatics, possibly because of a higher use of inhaled corticosteroids. The occurrence of idiopathic chronic eosinophilic pneumonia in asthmatics is often associated with the development of severe asthma.

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