tag:blogger.com,1999:blog-12660458.post115288275515719087..comments2023-09-01T10:33:09.297-04:00Comments on Pulmonary Roundtable: 56 year old woman with eosinophiliaUnknownnoreply@blogger.comBlogger4125tag:blogger.com,1999:blog-12660458.post-1154971870086659882006-08-07T13:31:00.000-04:002006-08-07T13:31:00.000-04:00Follow-up seen here:http://pulmonaryroundtable.blo...Follow-up seen here:<BR/>http://pulmonaryroundtable.blogspot.com/2006/07/more-on-woman-with-eosinophilia.htmlJenningshttps://www.blogger.com/profile/04930453447603683057noreply@blogger.comtag:blogger.com,1999:blog-12660458.post-1152908859311830392006-07-14T16:27:00.000-04:002006-07-14T16:27:00.000-04:00The multiple courses of steroids may falsely lower...The multiple courses of steroids may falsely lower Mendez's IgE level. A RAST against aspergillus would be helpful, but at Beaumont, it is much easier to get serum precipitans to AF. I am not sure what is easier at U of M or HFH.<BR/>Agreed with CEP as the diagnosis (again, assuming JCH's urine is without RBC's and the ANCA is negative).Mike Lhttps://www.blogger.com/profile/12177750268091750583noreply@blogger.comtag:blogger.com,1999:blog-12660458.post-1152890890013131762006-07-14T11:28:00.000-04:002006-07-14T11:28:00.000-04:00I forgot to add a very important thing: she presen...I forgot to add a very important thing: she presented to the hospital with nausea, vomiting and mild, loose sttols/diarrhea. She cannot tolerate PO's. We sent the O&P, ANCA's, IgE as suggested.Jenningshttps://www.blogger.com/profile/04930453447603683057noreply@blogger.comtag:blogger.com,1999:blog-12660458.post-1152886363979093552006-07-14T10:12:00.000-04:002006-07-14T10:12:00.000-04:00I agree--even the pattern on CT, with more periphe...I agree--even the pattern on CT, with more peripheral infiltrates, is consistent with chronic eosinophilic pneumonia. <BR/><BR/>The liklihood of Wegener's here seems pretty low, and I'd accept a negative C-ANCA and a bland urine microscopy as excluding it. There is no bronciectasis, which would be more likely with ABPA or churg-strauss, and "asthma" symptoms don't seem to be a prominent feature of her current presentation. Additionally, you havn't described any sinus-related symptoms, which could be associated with those diagnoses. Biopsy had no evidence of vasculitis, although a TBBX is not definitive. Moreover, these are less likely to have profound eosinophilia on the BAL.Jeff Hhttps://www.blogger.com/profile/01209432708535732499noreply@blogger.com