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All the following are features of Tropical pulmonary Eosinophilia except (AIPG 2010)

A Eosinophilia> 3000 μmm3

B Microfilaria in blood

C Paroxysmal cough and wheeze

D Bilateral chest mottling and increased bronchovascular markings

Ans. B

Microfilaria in blood

Tropical Pulmonary Eosinophilia (TPE)

In a distinct syndrome that develops in individuals infected with lymph node filarial species.

Clinical symptoms result from allergic and inflammatory reaction elicited by the cleared parasites.

Features of TPE:

1). Male more commonly affected than females (4:1)

2). History of residence in filarial endemic region

3). Paroxysmal cough and wheezing that are usually nocturnal.

4). Weight loss, low grade fever, adenopathy

5). Eosinophilia> 3000 eosinophil / μLQ

6). Chest X-Ray: increased bronchovascular markings, diffuse miliary lesions, or mottled opacities.

7). Restrictive changes on Pulmonary function test

8). Elevated levels of IgE & Antifilarial antibody titers.

9). In TPE, Microfilaria are rapidly cleared from the blood stream by the lungs. Thus, micro filariae are sequestrated in the lung and are not found in the blood.