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eosinophilic bronchitis

Etiology: - idiopathic Pathology: - eosinophilic infiltration of the bronchial mucosa Clinical manifestations: - dry, non-productive chronic cough Laboratory: - complete blood count: eosinophil count may be normal [3] - sputum eosinophils &/or fraction of exhaled nitric oxide Special laboratory: - pulmonary function tests normal - methacholine challenge test normal - bronchoscopy with bronchial mucosal biopsy required for definitive diagnosis - diffuse nodules in the tracheobronchial mucosa [3] (see image) Radiology: - chest X-ray normal Differential diagnosis: - upper airway cough syndrome (postnasal drip) Management: - therapeutic trial of inhaled glucocorticoids prior to extensive workup - systemic glucorticoids for 1 month (case report) in addition to inhaled glucocorticoids after diagnosis by bronchoscopy with bronchial mucosal biopsy [3] - continue inhaled glucocorticoid for an additonal 2 months (case report) [3] - prognosis: no recurrence at 6 months (case report) [3]

Related

eosinophilic pneumonia; Andrews syndrome; pulmonary eosinophilia

General

chronic bronchitis

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 16, 19. American College of Physicians, Philadelphia 2012, 2021
  2. Desai D, Brightling C. Cough due to asthma, cough-variant asthma and non-asthmatic eosinophilic bronchitis. Otolaryngol Clin North Am. 2010 Feb;43(1):123-30 PMID: 20172262
  3. Ren Y, Dai H. Images in Clinical Medicine: Eosinophilic Bronchitis. N Engl J Med 2017; 377:873. August 31, 2017 PMID: 28854083 http://www.nejm.org/doi/full/10.1056/NEJMicm1616156