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Acute eosinophilic pneumonia (AEP) Due to Daptomycin: Is Autoimmunity a Clinico-Pathophysiologic Bridge to AEP?

International Journal of Clinical Medicine 2024年第8期15卷 365-374页

作者： Shadee Tajik Sami Akram Department of Internal Medicine School of Medicine Southern Illinois University Springfield IL USA Department of Infectious Disease School of Medicine Southern Illinois University Springfield IL USA

Daptomycin induced acute eosinophilic pneumonia is a rare and potentially life threatening condition characterized by rapid respiratory failure, pulmonary infiltrates and eosinophilia. Risk factors for acute eosinophilic pneumonia include smoking, environmental irritants or inhalants and certain medications such as Daptomycin [1]. In this review of literature, we aim to explore the potential triggers for developing acute eosinophilic pneumonia in patients exposed to Daptomycin. The exact immune mechanism for daptomycin induced AEP is unknown, however the current proposed mechanism describes a T helper 2 lymphocyte response to inactivated daptomycin in the pulmonary surfactant, which leads to eosinophilia. Disordered T regulatory cell function is seen in patients with certain cancers, allergies and autoimmune conditions. We propose that patients with these underlying risk factors may be at increased risk of developing AEP after becoming exposed to Daptomycin. Understanding potential risk factors is crucial for health care workers as it allows them to identify susceptible populations, explore preventative measures and treat accordingly.

关键词： Daptomycin Acute eosinophilic Pneumonitis Daptomycin Induced Acute eosinophilic pneumonia Drug Induced pneumonia eosinophilic pneumonia

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Successful treatment of acute relapse of chronic eosinophilic pneumonia with benralizumab and without corticosteroids:A case report

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World Journal of Clinical Cases 2022年第18期10卷 6105-6109页

作者： Shimon Izhakian Barak Pertzov Dror Rosengarten Mordechai R Kramer Pulmonary Institute Rabin Medical CenterPetach Tikva 49100Israel Affiliated to Sackler Faculty of Medicine Tel Aviv UniversityRamat AvivIsrael

BACKGROUND Currently,the mainstay of chronic eosinophilic pneumonia(CEP)treatment is corticosteroids,usually with a favorable response and good ***,relapse is common,requiring long-term use of corticosteroids,with risk of significant treatment-related *** dire need to develop new treatments for patients with CEP,who are dependent on,or resistant to corticosteroids has led to exploring novel *** herein describe a patient with acute relapse of CEP,who was successfully treated with benralizumab,an IL-5 Rαantagonist that has demonstrated rapid anti-eosinophil action in patients with ***,only three recent patient reports on CEP relapse,also demonstrated successful treatment with benralizumab alone,without *** SUMMARY A 31-year-old non-smoking woman presented in our hospital with a 3 wk history of shortness of breath,dry cough and fever up to 38.3℃.Laboratory examination revealed leukocytosis 10240 K/μL,eosinophilia 900 K/μL and normal values of hemoglobin,platelets,creatinine and liver *** tomography of the chest showed a mediastinal lymphadenopathy and consolidations in the right upper and left lower *** was diagnosed,and the patient was treated with hydrocortisone intravenously,followed by oral prednisone,with prompt *** months later,she presented with relapse of CEP:aggravation of dyspnea,rising of eosinophilia and extension of pulmonary infiltrates on chest *** was treated with benralizumab only,with clinical improvement within 2 wk,and complete resolution of lung infiltrates following 5 *** Due to Benralizumab’s dual mechanism of action,it both neutralizes IL-5 Rαpro-eosinophil functions and triggers apoptosis of *** therefore maintain benralizumab can serve as a reasonable therapy choice for every patient with chronic eosinophilic pneumonia and a good alternative for corticosteroids.

关键词： Benralizumab eosinophilic pneumonia Interstitial lung disease Corticosteroid withdrawal Case report

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