Acute Eosinophilic Pneumonia Complicated with Venous Thromboembolic Disease-Diagnostic and Therapeutic Considerations

Acute Eosinophilic Pneumonia (AEP) is a rare idiopathic disease caused by an accumulation of eosinophils in the pulmonary alveoli and interstitial tissue of the lungs. The onset of symptoms is acute; some patients develop respiratory failure. The diagnosis is based on clinical symptoms, diffuse interstitial infiltrates in the lungs on imaging studies, and eosinophilia exceeding 25% on bronchoalveolar lavage or pleural fluid smear. Smokers are primarily at increased risk for the disease. We present a case of venous thromboembolic disease (VTE) that developed in the course of AEP in a previously healthy male smoker. Complete remission of the disease was achieved with anticoagulation therapy combined with a low dose of steroids. Surprisingly, further diagnostics revealed the presence of thrombophilia: antithrombin (AT) deficiency and increased homocysteine level. According to our knowledge, this is the first case of VTE diagnosed in the course of AEP combined with thrombophilia.

Automated summary

Acute Eosinophilic Pneumonia is a rare disease characterized by eosinophil accumulation in the lungs. Its onset is acute, and some patients may experience respiratory failure. Diagnosis is based on clinical symptoms, imaging studies, and eosinophilia in bronchoalveolar lavage or pleural fluid smear. Smokers are at an increased risk. We present a case of venous thromboembolic disease that developed during AEP in a previously healthy male smoker. The disease achieved complete remission with anticoagulation therapy and low-dose steroids. Surprisingly, further diagnostics revealed thrombophilia in the patient.