A Case of Chronic Eosinophilic Pneumonia Successfully Treated with Suplatast Tosilate

Abstract

A 69-year-old man was admitted to our hospital because of fever and cough. Chest X-ray and CT film showed both air-space consolidation and ground-glass opacities in the right lung field. Eosinophilia was found in bronchoalveolar lavage fluid and specimens obtained by transbronchial lung biopsy confirmed infiltration of eosinophils in the lung tissue. When the patient was given 30mg/day of prednisolone, there was prompt relief of symptoms and radiological appearance. However, because of impaired hepatic function due to prednisolone, oral steroid therapy was discontinued after two weeks of administration. Three months later acute exacerbation was recognized with new patchy infiltrates in the left lung field, so from the clinical and pathological point of view we diagnosed this case as chronic eosinophilic pneumonia. The pulmonary opacities did not respond to 1600μg/day of inhaled beclomethasone dipropionate, so suplatast tosilate at a dose of 300mg/day was introduced. About a month later pulmonary infiltrates disappeared, and the patient is currently free of symptoms with no radiological abnormalities while still receiving the drug. Therefore, suplatast tosilate is considered to be effective for the treatment of chronic eosinophilic pneumonia.