Long standing untreated tropical pulmonary eosinophilia (TPE) generally results in interstitial lung disease (ILD), as underlying chronic inflammation heals by fibrosis. The presentation of TPE as ILD is a rare entity. A patient was evaluated for persistent cough over two years. High resolution computed tomography of the chest was suggestive for ILD in this case. The patient was diagnosed, however, with TPE based on persistent high eosinophil count, positive antifilarial antibody and dramatic response to diethylcarbamazepine. Follow-up HRCT of the chest after 16 months of treatment showed complete resolution of ground-glass opacities. A significant improvement in spirometry was also noted.
Mullerpattan J, Udwadia Z, Udwadia F. Tropical pulmonary eosinophilia: a review. Indian J Med Res 2013;138:295-302.
Udwadia FE. Tropical eosinophilia. In: Herzog H, editor. Pulmonary Eosinophilia: Progress in Pulmonary Research, Vol.VII. Basel: S. Karger; 1975:p. 35-155.
Neva FA, Ottesen EA. Tropical (filarial) eosinophilia. N Engl J Med 1978;289:1129-31.
Ottesen EA. Immunological aspects of lymphatic filariasis and onhocerciasis. Trans R SocTrop Med Hyg 1984;73:9-18.
Ray D, Abel R, Selvaraj KG. Epidemiology of pulmonary eosinophilia in rural south India: a prospective study, 1981-86. J Epidemiol Community Health 1993;7:469-74.
Viswanathan R, Prasad M, Prasad S, Saran R, Sinha TR, Sinha SP. Morbidity survey of jail population. Part I: incidence of certain chronic respiratory diseases with special reference to pulmonary eosinophilosis. Indian J Chest Dis Allied Sci 1965;7:142-5.
Udwadia FE. Pulmonary eosinophilia. Part I. 39. J Assoc Physicians India 1978;26:283-93.
Udwadia FE. Pulmonary eosinophilia. Part II. 40. J Assoc Physicians India 1978;26:429-37.
Lobos E, Ondo A, Ottesen EA, Nutman TB. Biochemical and immunologic characterization of a major IgE-inducing filarial antigen of Brugia malayi and implications for the pathogenesis of tropical pulmonary eosinophilia. J Immunol 1992;149:3029-34.
Vijayan VK. Tropical pulmonary eosinophilia: pathogenesis, diagnosis and management. Curr Opin Pulm Med 2007;13:428-33.
Freedman DO, Nutman TB, Ottesen EA. Protective immunity in bancroftian filariasis: selective recognition of a 43-KD larval stage antigen by infection-free individuals in anendemic area. J Clin Invest 1989;83:14-22.
Udwadia FE. Tropical eosinophilia: a correlation of clinical, histopathologic and lung function studies. Indian J Chest Dis Allied Sci 1967;52:531-8.
Vijayan VK, Sankaran K, Venkatesan P, Kuppurao KV. Correlation of lower respiratory tract inflammation with changes in lung function and chest roentgenograms in patients with untreated tropical pulmonary eosinophilia. Singapore Med J 1991;32:122-5.
Crothers K, Rochester CL. The eosinophilic pneumonias. In: Fishman AP, Elias JA and Fishman JA, editors, Fishman's Pulmonary Diseases and Disorders; 4th edition. McGraw Hill Medical Ltd;2008:p.1218-20.