CHRONIC EOSINOPHILIC PNEUMONIA OR CARRING TONS DISEASE

Chronic eosinophilic pneumonia (CEP) was described by Carrington in 19 69. It is twice as common in women as it is in men and is probably mos t common at middle age. Symptoms usually associated fever, weight loss , fatigue and dyspnoea. Extra-respiratory manifestations are rare but may involve many organs. Classical radiological findings are diffuse a lveolar infiltrates, with a peripheral predominance which explains the classic description of a ''negative of pulmonary edema''. Peripheral blood eosinophilia is present in 90%. The inflammatory syndrome with a n eosinophilic alveolitis is constant. Pulmonary function tests show a restrictive pattern with depressed DLCO and hypoxemia. In atypical ca ses, proof of diagnosis is supported by lung biopsies that show intra alveolar and interstitial accumulation of eosinophils in peripheral ai r spaces. Areas of bronchiolitis obliterans are also frequently seen. In some atypical forms of chronic eosinophilic pneumonia, other disord ers have to be discussed, like bronchiolitis obliterans with an organi zing pneumonia or cryptogenetic organizing pneumonia and even tubercul osis. After corticosteroid therapy, the resolution occurs very rapidly but relapses are frequent. Steroid-dependance is seen in 20 to 30% of patients.