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CASE REPORT
Asthmatic adult with marked blood eosinophilia: is it truly asthma?
  1. Shera Tan1,
  2. Angela Takano2,
  3. Aloysius Ho3,
  4. Keng Leong Tan1
  1. 1Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore
  2. 2Department of Pathology, Singapore General Hospital, Singapore
  3. 3Department of Hematology, Singapore General Hospital, Singapore
  1. Correspondence to Dr Shera Tan, shera_TAN{at}ttsh.com.sg

Summary

A middle-aged woman presented with symptoms suggestive of allergic asthma but with markedly elevated peripheral eosinophilia. She did not respond to inhaled corticosteroids, thereby prompting further investigations. Chest radiograph was normal. CT of the chest revealed bi-apical ground glass opacities. Bronchoalveolar lavage revealed predominantly eosinophilic yield. Autoimmune screen was negative. Bone marrow biopsy showed a normocellular marrow with increased eosinophils. A diagnosis of chronic eosinophilic pneumonia (CEP) was made after exclusion of other causes of eosinophilia. Treatment of her CEP with systemic corticosteroids (prednisolone 0.5 mg/kg/day) resulted in dramatic improvement in symptoms and peripheral eosinophilia.

  • asthma
  • haematology (incl blood transfusion)
  • lung function

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Footnotes

  • Contributors ST prepared the manuscript, with intellectual input from AT, KLT and AH. AT prepared the histopathology slides for the article. ST accepts responsibility for the accuracy of the information presented in this manuscript. All correspondence should be made directly to her.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.