Feature Article

Eosinophilic lung diseases: an overview

Feature Article

Eosinophilic lung diseases: an overview

Michael Han, James Di Michiel, Lucy Morgan

Figures

© science rf/stock.adobe.com
© science rf/stock.adobe.com

Abstract

Eosinophilic lung diseases are characterised by elevated eosinophil levels with associated clinical, laboratory and radiographic features  and include allergic bronchopulmonary aspergillosis, acute and chronic eosinophilic pneumonias, eosinophilic granulomatosis with polyangiitis and hypereosinophilic syndromes. The role of eosinophilic inflammation in other respiratory conditions (including asthma, chronic obstructive pulmonary disease and bronchiectasis) is increasingly recognised. Corticosteroid therapies are the cornerstone of treatment, and biologic agents now have an established role in the management of severe asthma and are under investigation in other eosinophilic lung diseases. 

Key Points

  • Other causes of peripheral eosinophilia, such as allergic disease, drug reaction and parasitic infection, should be excluded before a diagnosis of eosinophilic lung disease is made.
  • Specific clinical features may support diagnosis of particular conditions, for example, extrathoracic manifestations may suggest eosinophilic granulomatosis with polyangiitis, whereas recurrent severe asthma with evolving bronchiectasis may suggest allergic bronchopulmonary aspergillosis.
  • Most forms of eosinophilic lung disease are highly responsive to corticosteroid therapy.
  • The expanding role of biologic therapies targeting eosinophilic inflammation is an exciting area for future research in the management of these conditions.