Chronic eosinophilic pneumonia due to radiographic contrast administration: an orphan disease?

Abstract

Wolfgang Hohenforst-Schmidt,1 Andreas Riedel,1 Paul Zarogoulidis,2,3 Christian Franke,4 Andreas Gschwendtner,5 Haidong Huang,6 Nikolaos Machairiotis,2 Vasiliki Dramba,2 Konstantinos Zarogoulidis,2 Johnannes Brachmann11II Medical Clinic, Coburg Clinic, University of Würzburg, Coburg, Germany; 2Pulmonary Department, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece; 3Pulmonary Department–Interventional Unit, University of Duisburg-Essen, Essen, Germany; 4Pulmonary Department, Sonneberg, Germany; 5Institute for Pathology, Coburg Clinic, University of Würzburg, Coburg, Germany; 6Department of Respiratory Diseases, Changhai Hospital, Second Military Medical University, Shanghai, ChinaAbstract: Pulmonary eosinophilia comprises a heterogeneous group of diseases that are defined by eosinophilia in pulmonary infiltrates or in tissue. Drugs can cause almost all histopathologic patterns of interstitial pneumonias, such as cellular and fibrotic nonspecific interstitial pneumonia, pulmonary infiltrates and eosinophilia, organizing pneumonia, lymphocytic interstitial pneumonia, desquamative interstitial pneumonia, a pulmonary granulomatosis-like reaction, and a usual interstitial pneumonia-like pattern. We present a very rare case of chronic eosinophilic pneumonia due to radiographic contrast infusion diagnosed with video-assisted thoracoscopy. The patient after 1 year is still under corticosteroid treatment with the disease stabilized.Keywords: interstitial lung disease, radiographic contrast, orphan disease