LONG-TERM FOLLOW-UP OF PULMONARY-FUNCTION IN CHRONIC EOSINOPHILIC PNEUMONIA

The prognosis of chronic eosinophilic pneumonia (CEP) is usually good under corticosteroid therapy (CST). The main complications are relapse s when treatment is tapered or discontinued. The aim of this retrospec tive, multicentre study was to evaluate the long-term consequences of CEP on pulmonary function tests.Nineteen patients (mean+/-SEM age 51+/ -16 yrs) with CEP were studied. Lung function tests were performed at the time of diagnosis and at follow-up, and included flow-volume curve . The results of the first pulmonary function test were normal in six patients, restrictive in nine, and obstructive in four. Relapses (recu rrence of initial signs) occurred in nine patients. The last evaluatio n (mean+/-SEM follow-up of 49+/-44 months, range 12-142 months) showed a complete recovery in 8 of the 19 patients. One patient developed bi lateral apical fibrosis. The remaining 10 patients, exhibited obstruct ive pulmonary function without relapse of CEP at this time. Bronchoalv eolar lavage (BAL) eosinophilia at the time of the initial evaluation tended to be higher (p=0.05) in these 10 patients than in those with n ormal pulmonary function findings at follow-up. This study demonstrate s: firstly, that the development of an obstructive ventilatory defect is a common finding during the course of chronic eosinophilic pneumoni a (CEP); secondly, that bronchial obstruction might appear despite the absence of clinical and radiological signs of relapse; and, thirdly, that a markedly increased bronchoalveolar lavage eosinophilia at the i nitial evaluation is associated with a higher risk of development of b ronchial obstruction. These results suggest that pulmonary function te sts should be included in the management of chronic eosinophilic pneum onia.