Chronic eosinophilic pneumonia: treatment with inhaled corticosteroids

Respiration. 2003 Jul-Aug;70(4):362-6. doi: 10.1159/000072898.


Background: Chronic eosinophilic pneumonia (CEP) is highly sensitive to systemic corticosteroids, but frequently relapses if the dose is tapered or treatment discontinued. Long-term usage of systemic corticosteroids may cause side effects. Alternative treatments are therefore desired.

Objectives: We evaluated the response of CEP to monotherapy with inhaled corticosteroids (ICS).

Methods: Four patients who had CEP without spontaneous resolution were studied. Patients received inhaled beclomethasone dipropionate (BDP) at a dose of 0.8 mg/day in 1 patient and 1.6 mg/day in 3 patients for 2 weeks. Treatment was continued if a patient showed improvement in at least 1 of the following indices: radiological findings, symptoms, and blood eosinophilia.

Results: After the initial 2 weeks of treatment with BDP, the blood eosinophil count increased in 2 patients and decreased in 2. Symptoms worsened in 2 and improved in 2. Infiltrates on chest radiography increased in 3 and showed little change in 1. In the 2 patients with worsening of all 3 outcome indices, oral prednisolone was started; the indices improved. In the remaining 2 patients, BDP alone was continued. One patient had worsening of CEP after 2 months of treatment, and another had relapse of CEP at 3.5 years while receiving 1.6 mg/day of BDP. All patients thus finally had worsening or relapse of CEP during treatment with BDP.

Conclusions: ICS may not be effective when given as monotherapy in patients with CEP.

MeSH terms

  • Administration, Inhalation
  • Administration, Oral
  • Anti-Inflammatory Agents / administration & dosage*
  • Anti-Inflammatory Agents / adverse effects
  • Asthma / complications
  • Beclomethasone / administration & dosage*
  • Beclomethasone / adverse effects
  • Blood Cells / pathology
  • Chronic Disease
  • Eosinophils / pathology
  • Female
  • Follow-Up Studies
  • Glucocorticoids / administration & dosage*
  • Glucocorticoids / adverse effects
  • Humans
  • Leukocyte Count
  • Middle Aged
  • Prednisolone / administration & dosage
  • Pulmonary Eosinophilia / complications
  • Pulmonary Eosinophilia / drug therapy*
  • Pulmonary Eosinophilia / pathology
  • Pulmonary Eosinophilia / physiopathology
  • Respiratory Function Tests
  • Time Factors
  • Treatment Failure


  • Anti-Inflammatory Agents
  • Glucocorticoids
  • Prednisolone
  • Beclomethasone