Eosinophilic Pneumonia Explained Clearly by MedCram.com | 2 of 2

Eosinophilic Pneumonia Explained Clearly by MedCram.com | 2 of 2

okay well welcome to another MedCram
lecture presented at med crammed calm please join us over there at MIT cram
comm where we’ve got great videos and reviews we’re gonna talk about again
eosinophils pneumonia and we’re gonna round out this lecture with the top four
that I think you ought to know and let’s get started first of all it’s name what
they are the primary eosinophilic pneumonia is and divide them into two
categories we’re going to talk about the lung and systemic so there’s one in the
lungs there are those systemic so actually two in the lungs and two of
them that are systemic the first one is acute Jacinta philic
pneumonia then we have chronic you’ll Cinna philic pneumonia and then here we
have the hyper yo Cinna philic syndrome I should say not pneumonia and finally
the what we call e.g PA which you should know stands for the eosinophilic
granulomatosis with polyangiitis otherwise known as CH you are gee that’s
churg-strauss str2 str1 and they are different in some ways first of all
let’s talk about where the eosinophils are found now as I mentioned usually
they’re found in both the lungs and the blood and that’s the case here so here
I’m going to write both to show that it’s both in the blood and also in the
lungs here it’s us an affiliate is found both in the lung and the blood and here
as well both in the lungs and the blood whereas here
it’s just found in the lungs so no blood the way to think about that is an acute
eosinophils pneumonia it’s starting in the lungs it doesn’t have time to make
it into the blood that might be a way to think about it the next thing we want to
look at is the the agender predilection so whereas this is the unique one in
terms of where the eosinophilia is found this one here is the unique one in terms
of the fact that it’s typically found in females whereas every other one is
typically male predominant okay now in terms of markers you should know
that this one is unique in that the major marker is P ANCA and all the other
ones have il 5 mediation which makes sense because that’s the major issue
with eosinophils the other thing that’s of course
interesting is that you’re gonna get vasculitis and mono Plex neuropathy
so neuropathy and vasculitis now the theory is is that when people are put on
leuco trying receptor antagonists that you’re able to as a result reduce the
steroids that you have to use in people with asthma and as a result of that when
you reduce the steroids it tends to cause this short strauss
disease to come out now this has led some people to believe that the that
there actually is a connection between LT Ras and this disease but that is
hotly debated with eg PA or Turk Straus syndrome the the biggest issue is
morbidity and mortality from the heart or cards it is typically seen in asthma
so we’ll put that in a different color here for you
asthma is big here of course in chronic eosinophils pneumonia asthma is also big
the other interesting thing here is that that it’s predominately in women but
also on the x-ray it has the photographic
negative of pulmonary oedema what do I mean by that if you were to look on the
x-ray whereas in pulmonary edema typically
it’s starting from the middle which is what the vascularity is here it’s
towards the edge okay now the treatments for all of these
no surprise is steroids steroids for acute eosinophils pneumonia and usually
there is no relapse for chronic OSA no philic pneumonia you guessed it
steroids and they can get better within hours two days but there may be a
relapse so they need a longer course perhaps even months typically months to
make sure that the chronic ear DaSilva pneumonia doesn’t come back for Hyper yo
Sinha philic syndrome the treatment is steroids as well but in this case
because the il5 you may use in il5 inhibitor which as you may recall is
meeple is you map okay and then the treatment here in trick Straus is
steroids but you can also do more rigorous steroids for instance like
methotrexate and as a thigh print the other thing that you might see as well
is elevated IgE levels okay so what are the things that I think are going to be
important to understand for this you’ve got to know for you of synthetic
pneumonias that number one acute eosinophils ammonia is only in the lungs
so the only way you’re going to make the diagnosis is if you do a B al that’s a
bronchial alveolar lavage or a bronchus bronchoscopy all the other ones are both
in the lungs and in the serum in terms of women this is the one they’re gonna
get most often the chronic the other thing you ought to know is the
photographic negative of pulmonary edema that’s very important these two are both
very responsive to steroids the acute does not relapse
and you can think of it that it doesn’t relapse because it’s only in the lungs
and it’s only in the lungs because it hasn’t had a chance to spread to the
blood and that’s because it’s acute for hyper eosinophils syndrome you’re going
to see multiple parts of the body multiple organs involved you can because
it’s il5 mediated specifically here you can use mutilation map which is an auto
antibody against il5 but the treatment is steroids and typically to get this
diagnosis you need to have this for at least six months so this is not a easy
diagnosis sometimes over here they have asthma for up to ten years so just so
you’re aware of that so trick strauss remember that
medications like leukotriene receptor antagonists like montelukast can unmask
it it’s typically seen both in the blood and also in the lungs typically male
this Pianka is gonna give you a vasculitis that is going to give you
purpura it could give you nodules petechiae you can even get a diffuse
alveolar hemorrhage very rarely it’s not common you’re gonna get neuropathy and
you’re gonna get morbidity and mortality from cardiology issues remember steroids
as a thyroid prynne and methotrexate okay so a big picture know the
difference between acute and chronic and then know both or lungs thanks for
joining us

4 Replies to “Eosinophilic Pneumonia Explained Clearly by MedCram.com | 2 of 2”

  1. Over 100 hours of free medical videos by Dr. Seheult at www.MedCram.com
    Cardiology, Critical Care, Pharmacology, Pulmonology, Infectious Disease, Acid/Base, Hematology, Radiology, and more…

  2. Could you help me get to know more? I got diagnosed with Aep and asthma but something I cannot get my head around is that I'm coughing up bronchial casts along with a milky white sputum which has not really been explained to me any idea.?

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