Loffler Syndrome Medication

  • Author: Girish D Sharma, MD; Chief Editor: Michael R Bye, MD   more...
 
Updated: Apr 4, 2012
 

Medication Summary

The minimal nature of symptoms in most patients with Löffler syndrome usually denotes that no pharmacologic therapy is required for this self-limiting condition. For drug-induced pulmonary eosinophilia, discontinue administration of the offending drug. When a parasitic infection is documented, appropriate use of anthelmintic drugs is indicated. In severe cases of simple pulmonary or drug-induced eosinophilia, systemic corticosteroids are highly effective.

Next

Corticosteroids

Class Summary

Markedly reduce the survival of certain inflammatory cells, including eosinophils. Eosinophil survival is dependent on the presence of certain cytokines (eg, interleukin-5 [IL-5], granulocyte macrophage colony stimulating factor and [GM-CSF]), whose effects are blocked by administration of corticosteroids.

View full drug information

Prednisone (Deltasone, Meticorten, Orasone, Sterapred)

 

May decrease inflammation by reversing increased capillary permeability and suppressing PMN activity.

Previous
Proceed to Follow-up
 
 
Contributor Information and Disclosures
Author

Girish D Sharma, MD  Professor of Pediatrics, Rush Medical College; Senior Attending, Department of Pediatrics, Director, Section of Pediatric Pulmonology and Rush Cystic Fibrosis Center, Rush University Medical Center

Girish D Sharma, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American Thoracic Society, and Royal College of Physicians of Ireland

Disclosure: Nothing to disclose.

Coauthor(s)

Michael J Vinikoor, MD  Fellow in Infectious Diseases, Department of Internal Medicine, University of North Carolina at Chapel Hill School of Medicine

Michael J Vinikoor, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Specialty Editor Board

Girish D Sharma, MD  Professor of Pediatrics, Rush Medical College; Senior Attending, Department of Pediatrics, Director, Section of Pediatric Pulmonology and Rush Cystic Fibrosis Center, Rush University Medical Center

Girish D Sharma, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American Thoracic Society, and Royal College of Physicians of Ireland

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Charles Callahan, DO  Professor, Deputy Chief of Clinical Services, Walter Reed Army Medical Center

Charles Callahan, DO is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American College of Osteopathic Pediatricians, American Thoracic Society, Association of Military Surgeons of the US, and Christian Medical & Dental Society

Disclosure: Nothing to disclose.

Mary E Cataletto, MD  Director of Children's Sleep Services, Winthrop Sleep Disorders Center; Professor of Clinical Pediatrics, State University of New York at Stony Brook

Mary E Cataletto, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Chest Physicians

Disclosure: Shering Plough Pharmaceuticals Honoraria Consulting

Chief Editor

Michael R Bye, MD  Professor of Clinical Pediatrics, Division of Pulmonary Medicine, Columbia University College of Physicians and Surgeons; Attending Physician, Pediatric Pulmonary Medicine, Morgan Stanley Children's Hospital of New York Presbyterian, Columbia University Medical Center

Michael R Bye, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, and American Thoracic Society

Disclosure: Nothing to disclose.

References

  1. Kunst H, Mack D, Kon OM, et. al. Parasitic infections of the lung: a guide for the respiratory physician. Thorax. 2011;66:528-36.

  2. Plotz SG, Huttig B, Aigner B. et al. Clinical overview of cutaneous features in hypereosinophilic syndrome. Current Allergy Asthma Report. 2012;12:85-98.

  3. Shinde A, Seifi A, DelRe S, et al. Daptomycin-induced pulmonary infiltrates with eosinophilia. J Infect. Feb 2009;58(2):173-4. [Medline].

  4. Janz DR, O'Neal HR Jr, Ely EW. Acute eosinophilic pneumonia: A case report and review of the literature. Crit Care Med. Apr 2009;37(4):1470-4. [Medline].

  5. [Guideline] Institute for Clinical Systems Improvement (ICSI). Diagnosis and treatment of respiratory illness in children and adults. Jan 2008;[Full Text].

  6. Abdul-Hadi S, Diaz-Bello Z, Zavala-Jaspe R, et al. Pulmonary paragonimiasis. Case report. Invest Clin. Jun 2008;49(2):257-64. [Medline].

  7. Alberts WM. Eosinophilic interstitial lung disease. Curr Opin Pulm Med. Sep 2004;10(5):419-24. [Medline].

  8. Allen JN, Davis WB. Eosinophilic lung diseases. Am J Respir Crit Care Med. Nov 1994;150(5 Pt 1):1423-38. [Medline].

  9. Carroll JL, Sterni LM. Eosinophilic lung disorders and hypersensitivity pneumonitis. In: Taussig LM, Landau LI, eds. Pediatric Respiratory Medicine. St Louis, Mo: Mosby; 1999:804-10.

  10. Corrin B. The lungs. In: Systemic Pathology. 3rd ed. London, England: Churchill Livinstone; 1990:191.

  11. Cottin V, Cordier JF. Eosinophilic pneumonias. Allergy. Jul 2005;60(7):841-57. [Medline].

  12. Crofton JW, Livingstone JL, Oswald NC, Roberts AT. Pulmonary eosinophilia. Thorax. Mar 1952;7(1):1-35. [Medline].

  13. Das AM, Williams TJ, Lobb R, Nourshargh S. Lung eosinophilia is dependent on IL-5 and the adhesion molecules CD18 and VLA-4, in a guinea-pig model. Immunology. Jan 1995;84(1):41-6. [Medline].

  14. Fujimura M, Yasui M, Shinagawa S, et al. Bronchoalveolar lavage cell findings in three types of eosinophilic pneumonia: acute, chronic and drug-induced eosinophilic pneumonia. Respir Med. May 1998;92(5):743-9. [Medline].

  15. Katz U, Shoenfeld Y. Pulmonary eosinophilia. Clin Rev Allergy Immunol. Jun 2008;34(3):367-71. [Medline].

  16. Kaufman J, O'Shaughnessy IM. Eosinophilic pleural effusion associated with valproic acid administration. South Med J. Aug 1995;88(8):881-2. [Medline].

  17. Kim Y, Lee KS, Choi DC, et al. The spectrum of eosinophilic lung disease: radiologic findings. J Comput Assist Tomogr. Nov-Dec 1997;21(6):920-30. [Medline].

  18. Lee HK, Jin SL, Lee HP, et al. Loffler's syndrome associated with Clonorchis sinensis infestation. Korean J Intern Med. Dec 2003;18(4):255-9. [Medline].

  19. Ler WZ. Differential-diagnose der lungen infiltrierungen: er fle succedan-infiltrate (mit eosinophilia). Beitr Klin Tuberk. 1932;79:368-92.

  20. Nadeem S, Nasir N, Israel RH. Loffler's syndrome secondary to crack cocaine. Chest. May 1994;105(5):1599-600. [Medline].

  21. Neva FA, Brown HW. Intestinal nematodes. In: Basic Clinical Parasitology. 6th ed. Norwalk, Conn: Appleton & Lange; 1994:113-51.

  22. Nogami M, Suko M, Okudaira H, et al. Experimental pulmonary eosinophilia in mice by Ascaris suum extract. Am Rev Respir Dis. May 1990;141(5 Pt 1):1289-95. [Medline].

  23. O'Sullivan BP, Nimkin K, Gang DL. A fifteen-year-old boy with eosinophilia and pulmonary infiltrates. J Pediatr. Oct 1993;123(4):660-6. [Medline].

  24. Ohnishi H, Abe M, Yokoyama A, et al. Clarithromycin-induced eosinophilic pneumonia. Intern Med. Mar 2004;43(3):231-5. [Medline].

  25. Pawlowski ZS. Ascariasis. In: Warren KS, Mahmoud AAF, eds. Tropical and Geographical Medicine. 2nd ed. New York, NY: McGraw-Hill; 1990:369.

  26. Sharma OP, Bethlem EP. The pulmonary infiltration with eosinophilia syndrome. Curr Opin Pulm Med. Sep 1996;2(5):380-9. [Medline].

  27. Takafuji S, Nakagawa T. Drug-induced pulmonary disorders. Intern Med. Mar 2004;43(3):169-70. [Medline].

  28. Wang J, Palmer K, Lotvall J, et al. Circulating, but not local lung, IL-5 is required for the development of antigen-induced airways eosinophilia. J Clin Invest. Sep 15 1998;102(6):1132-41. [Medline]. [Full Text].

  29. Wong-Waldamez A, Silva-Lizama E. Bullous larva migrans accompanied by Loeffler's syndrome. Int J Dermatol. Aug 1995;34(8):570-1. [Medline].

 
Previous
Next
 
Initial chest radiograph of a 54-year-old man showing subtle opacity (arrows) in the right middle lung zone.
Follow-up chest radiograph of a 54-year-old man showing migrating opacity in the left lower lobe (arrows) obtained 20 days after the previous image.
High-resolution CT scan (1 mm collimation) obtained in a 54-year-old man showing consolidation with surrounding ground-glass opacity in the left lower lobe. Dilated airways are observed within the lesion. This CT scan was obtained between the first and second images above.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.