Tropical Pulmonary Eosinophilic Infiltration Syndrome
Introduction
Introduction to tropical pulmonary eosinophilic infiltration Tropical erosive eosinophilia (TEPI), also known as Weingarten syndrome. basic knowledge The proportion of illness: 0.003% Susceptible people: no special people Mode of infection: non-infectious Complications: heart failure
Cause
Causes of tropical pulmonary eosinophilic infiltration
(1) Causes of the disease
Closely related to the infection of the filariasis, the adult filariae parasitic in the lymphatic system produce a large number of microfilariae, and some enter the blood circulation to cause an allergic reaction in the lung. Most of the patients have anti-filaria antibodies in the serum, and the filarial antigen The complement fixation test is positive, and the titer decreases after anti-filaria treatment. In typical patients, microfilariae can be found in the liver, lung and lymph nodes, and other parasitic diseases such as aphids, hookworms, and bowworms Infection may also cause this disease.
(two) pathogenesis
Histopathological findings are related to the course of the disease. In the acute phase, diffuse eosinophil infiltration can be seen in the alveolar, interstitial, peribronchial and vascular lumens, and eosinophilic microabscesses and granuloma can be formed. Degeneration of micro-abscess can be found in the microabscess center. Silkworm, in the late stage, can be seen in a variety of inflammatory cell infiltration and fibrosis, lymph node, liver and lung biopsy specimens can be seen degenerate microfilaria or adult, surrounded by eosinophils and their granular products and giant cells aggregate.
Prevention
Tropical pulmonary eosinophilic infiltration prevention
Pay attention to the diet and pay attention to personal living habits.
Complication
Complications of tropical pulmonary eosinophilic infiltration Complications heart failure
Pulmonary heart failure, abnormal breathing.
Symptom
Symptoms of tropical pulmonary eosinophilic infiltration Common symptoms Low fever diarrhea Eosinophilia Lack of lymphadenopathy Lung sounds of the lungs can be smelled and wet...
Common clinical symptoms include cough, wheezing, low fever, weight loss, fatigue and anorexia, coughing is vigorous and paroxysmal, nighttime is heavy, sputum is sticky, sometimes bloody in the sputum, often with asthma-like attacks, a few patients may have lungs External manifestations such as vomiting, diarrhea, pericarditis and central nervous system symptoms, physical examination can be found in the lungs wheezing sounds and dry and wet voices and mild liver, spleen, lymph nodes.
According to clinical manifestations, combined with laboratory tests can be diagnosed.
Examine
Examination of tropical pulmonary eosinophilic infiltration
1. Peripheral blood: The total number of white blood cells is increased, and the eosinophil count is significantly increased, often exceeding 3000/mm3 for several weeks.
2. X- ray examination: typical X-ray signs of the lungs are reticular nodular shadows with blurred boundaries, mainly distributed in the lungs of the lower lungs, occasionally hilar lymphadenopathy and pleural effusion, and patients with advanced lungs often remain in the lungs. Fibrosis, but the increase in eosinophils was not associated with disease severity and chest X-ray findings.
3. Serum total IgE: also increased accordingly, can be higher than 1000U / ml (1U = 2.2ng).
4.ESR: Moderately increased.
5. Sputum examination: eosinophils can be seen, and 20% of patients have positive fecal silkworm eggs.
6. Patient serum filarial specific IgE and IgG: titer detection and serum complement binding or agglutination test.
7. Pulmonary function test: Early indications of impaired ventilatory function, and restrictive ventilatory dysfunction with diffuse function decline in the late stage.
8. Bronchoalveolar lavage fluid (BALF): The proportion of eosinophils is significantly increased, often >25%.
9. CT scan : helpful for differential diagnosis of shadows.
Diagnosis
Diagnosis and diagnosis of tropical pulmonary eosinophilic infiltration
Note that it should be differentiated from acute and chronic eosinophilic pneumonia.
