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Tropical pulmonary Eosinophilia

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 / ml
  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.

Pulmonary infiltrates with eosinophilia: (PIE, eosinophilic pneumonias).

Constituted by distinct individual syndromes characterized by eosinophilic pulmonary infiltrates and peripheral blood eosinophilia.


These include (Ref. Hari. 18th ed., Table 255.2 Pg- 2120)



Etiology known


i. Allergic Bronchopulmonary aspergillosis

ii. Parasitic infestations

iii. Drug reactions

iv. Eosinophilia myalgia syndrome

i. Loeffler's syndrome

ii. Acute eosinophilic pneumonia

iii. Chronic eosinophilic pneumonia

iv. Allergic granulomatosis of Churg & Strauss Hypereosinophilic syndrome


Extra Edge:

Pulmonary eosinophilic granuloma is not a cause of peripheral eosinophilia.

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