Letter to the Editor
Eosinophlic pneumonia in a patient with anticentromere antibody
Neumonía eosinofílica en pacientes con anticuerpos anticentroméricos
Hiroaki Satoh
, Katsunori Kagohashi, Gen Ohara, Kunihiko Miyazaki, Koichi Kurishima
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Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba, Japan
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(Reumatol Clin 2012 May–June issue) on eosinophilic pneumonia in patients with autoimmune phenomenon or immunoallergic disease.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> We would like to share our experience with a patient whose condition was similar to that reported by Jaimes-Hernández et al.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">A 75-year-old woman was admitted to our hospital because of one-week history of left chest pain. She was never smoker. She had a seven-year history of atrial fibrillation and, thereafter, was prescribed warfarin. On admission, she had no rales in both lungs, and the musculoskeletal examination was also unremarkable. She had no Raynaud's phenomenon, screloderma, and dysphagia. The chest X-ray and computed tomography revealed bilateral nonsegmental peripheral infiltrates mainly in the left lung. Laboratory data on admission were as follows: white blood cell 4900/μL (eosinophils: 245/μL), C-reactive protein 3.77<span class="elsevierStyleHsp" style=""></span>mg/dL, anti-nuclear antibody 1:640, anticentromere antibody 1:640, rheumatoid factor 4<span class="elsevierStyleHsp" style=""></span>U/mL. RP3-ANCA, MPO-ANCA, anti-ribonucleoprotein antibody, and anti-topoisomerase l antibody were negative. All tests for acid-fast bacilli including culture, and serologic and microscopic testing for fungi was negative. A bronchoalveolar lavage obtained from left upper lobe showed total cell count 8.4<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">5</span>/mL with 16.7% eosinophilia. Transbronchial biopsy was not performed because the patient had warfarin for atrial fibrillation. The patient was diagnosed as having eosinophilic pneumonia and was started on 30<span class="elsevierStyleHsp" style=""></span>mg prednisolone per day. After two weeks of treatment pulmonary infiltrates had normalized. She was successfully weaned off the prednisolone over a period of two months and followed up without recurrence of eosinophilic pneumonia.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Although very rare, there have been some reports with regard to marked eosinophilic pulmonary infiltration in patients, who had high titers of antiautoimmune antibodies.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a> Both of them were diagnosed as having Churg-Straus syndrome.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a> Our patient had no sign and symptoms of Churg-Straus syndrome nor any autoimmune diseases.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Our patient had a high titer of anticentromere antibody in her serum without any symptoms of CREST syndrome. There might be a possibility that eosinophilic pneumonia developed incidentally in a patient with high titer of anticentromere antibody in serum. However, the case reported by Jaimes-Hernández et al.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> and ourselves suggested that a certain type of eosinophilic pneumonia might have some relationship with autoimmune phenomenon.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chronic eosinophilic pneumonia: autoimmune phenomenon or immunoallergic disease? Case report and literature review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Jaimes-Hernández" 1 => "A. Mendoza-Fuentes" 2 => "C.I. Meléndez-Mercado" 3 => "P. Aranda-Pereira" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.reuma.2011.09.005" "Revista" => array:6 [ "tituloSerie" => "Reumatol Clin" "fecha" => "2012" "volumen" => "8" "paginaInicial" => "145" "paginaFinal" => "148" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22196999" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A rare case of allergic granulomatous angitis (Churg Strauss syndrome) with positive anti-glomerular basement membrane (GBM) antibody in serum" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H. Masuzaki" 1 => "M. Iwanishi" 2 => "M. Umemiya" 3 => "K. Misaki" 4 => "S. Sumitomo" 5 => "N. Fujimura" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Nihon Kyobu Shikkan Gakkai Zasshi" "fecha" => "1991" "volumen" => "29" "paginaInicial" => "1644" "paginaFinal" => "1650" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1808391" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A case of Churg-Strauss syndrome in which MPO-ANCA (antibodies to myeloperoxidase) appeared to reflect the disease activity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Nakagawa" 1 => "T. Yamaguchi" 2 => "H. Amano" 3 => "T. Takao" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Nihon Kyobu Shikkan Gakkai Zasshi" "fecha" => "1995" "volumen" => "33" "paginaInicial" => "543" "paginaFinal" => "547" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7609341" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0015028206032766" "estado" => "S300" "issn" => "00150282" ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/1699258X/0000001000000003/v1_201405040016/S1699258X13001757/v1_201405040016/en/main.assets" "Apartado" => array:4 [ "identificador" => "17506" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Cartas al editor" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/1699258X/0000001000000003/v1_201405040016/S1699258X13001757/v1_201405040016/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X13001757?idApp=UINPBA00004M" ]
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