Acute eosinophilic pneumonia (AEP): A deadly and quiet disorder

Acute eosinophilic pneumonia (AEP): A deadly and quiet disorder

By Dr. Mohamed Rafique Head of Pulmonology and Sleep Medicine Medical Director of Prime Hospital

A rare and truly challenging disorder, Acute Eosinophilic Pneumonia (AEP) is characterized by the accum ulation of eosinophils in the lungs (pulmonary eosinophilia). Part of the immune system, Eosinophils are a type of white blood cell typically produced in response to allergens, inflammation or infection. They are also especially active in the respiratory tract.

There have been fewer than 200 cases of AEP on record, making it a very rare occurrence. The most common signs and symptoms associated with this disease includes progressive shortness of breath, acute respiratory failure, cough, fatigue, night sweats, fever, and rapid and unintended weight loss. More subtle signals can appeal in the form of fatigue muscle pain, joint aches, and abdominal discomfort or pain.

However, these mind symptoms can escalate and develop into acute respiratory failure which can occur when there is rapid drop in oxygen, which can lead to potentially life-threatening breathing complications. This highly dangerous occurrence can manifest within just a few days, or in extreme cases mere hours, that individuals experience the initial major symptoms. According to data, approximately two thirds of those with the affliction may require mechanical ventilation.

People who are susceptible to this particular disease must remain vigilant with regards to observing possible symptoms upon its onset. Typically, the symptoms associated with this disorder can evolve rapidly within 1 to 7 days, while in some cases, its development may be slow and can last up to an entire month. Unfortunately, young healthy and active individuals, particularly those between the age of 20 to 40 are most susceptible to AEP.

The most perplexing aspect of this disease is the fact that its cause has still not been determined by solid medical evidence. A number of reports suggested that it is a hypersensitive reaction to an unknown inhaled antigen among healthy individuals. Certain medical trends have noted a possible correlation to excessive use of tobacco and other smoking habits, as well as passive smokers. Drug intake has also been listed as a potential cause, including minocycline, daptomycin, and velafaxine, an antidepressant, among others. In a number of reports, the theories vary wildly from prevalence of outdoor activities, to a healthy male patient developing symptoms after inhaling smoke from fireworks.

Environmental causes have also been taken into account, especially in areas that are heavily exposed to dust and smoke, however this has not been isolated as the main cause and it is generally noted the trigger varies from one individual to another. In general, AEP seems to affect males, more than females.