eMedicine Specialties > Pediatrics: General Medicine > Pulmonology

Loffler Syndrome: Treatment & Medication

Author: Isaac Talmaciu, MD, Clinical Assistant Professor, Department of Pediatrics, Florida Atlantic University School of Medicine
Contributor Information and Disclosures

Updated: Jul 2, 2009

Treatment

Medical Care

Evaluation of Löffler syndrome can be conducted on an outpatient basis; inpatient care is not required.

Surgical Care

Surgical care is not indicated.

Consultations

Pediatric pulmonologist

Diet

No special diet is required.

Activity

No activity limitation is indicated.

Medication

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.

Corticosteroids

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.


Prednisone (Deltasone, Meticorten, Orasone, Sterapred)

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

Adult

5-60 mg/d PO divided qd/bid

Pediatric

0.5-2 mg/kg/d PO divided qd/bid; not to exceed 80 mg/d

Concurrent use with digoxin may cause digitalis toxicity secondary to hypokalemia; phenobarbital, phenytoin, and rifampin may increase metabolism of glucocorticoids (consider increasing maintenance dose); monitor for hypokalemia with coadministration of diuretics

Documented hypersensitivity; administration of corticosteroids to patients with S stercoralis infection (may lead to hyperinfection syndrome)

Pregnancy

B - Usually safe but benefits must outweigh the risks.

Precautions

Use with much caution in patients with peptic ulcer disease, hypertension, psychoses, diabetes, osteoporosis, varicella, and herpes infection; do not discontinue abruptly following use > 2 wk; observe carefully for the development of hyperglycemia, glycosuria, sodium retention with edema or hypertension, hypokalemia, peptic ulcer, osteoporosis, or hidden infections

More on Loffler Syndrome

Overview: Loffler Syndrome
Differential Diagnoses & Workup: Loffler Syndrome
Treatment & Medication: Loffler Syndrome
Follow-up: Loffler Syndrome
Multimedia: Loffler Syndrome
References
Further Reading
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References

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Keywords

Loffler syndrome, Löffler's syndrome, allergic bronchopulmonary helminthiasis, drug-induced pulmonary eosinophilia, simple pulmonary eosinophilia, parasitic infections, hypersensitivity reactions, eosinophilic pulmonary infiltrates, ascariasis, treatment, diagnosis

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Contributor Information and Disclosures

Author

Isaac Talmaciu, MD, Clinical Assistant Professor, Department of Pediatrics, Florida Atlantic University School of Medicine
Isaac Talmaciu, MD is a member of the following medical societies: American Academy of Pediatrics
Disclosure: Nothing to disclose.

Medical Editor

Girish D Sharma, MD, Associate Professor, Department of Pediatrics, Rush University Medical Center, Rush Children's Hospital; Director of Pediatric Pulmonary Section and Rush Cystic Fibrosis 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.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

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.

CME Editor

Mary E Cataletto, MD, Associate Director, Division of Pediatric Pulmonology, Winthrop University Hospital; Professor of Clinical Pediatrics, State University of New York at Stony Brook; Director of Children's Sleep Services, Winthrop University Hospital
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: Merck Honoraria Speaking and teaching

 
 
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