Löffler's Syndrome
Löffler's Syndrome
Löffler's syndrome, also known as eosinophilic pneumonia, is a rare respiratory disorder characterized by the accumulation of eosinophils in the lungs. It was first described by Wilhelm Löffler in 1932. This condition primarily affects children and young adults, although it can occur at any age.
Key Points:
- Rare respiratory disorder
- Characterized by eosinophilic infiltration of the lungs
- Can be idiopathic or secondary to various triggers
- Typically self-limiting, but may require treatment in severe cases
Etiology
Löffler's syndrome can be idiopathic or secondary to various triggers. Common causes include:
- Parasitic infections (e.g., Ascaris lumbricoides, Strongyloides stercoralis)
- Medications (e.g., NSAIDs, antibiotics, antipsychotics)
- Allergic reactions
- Fungal infections
- Autoimmune disorders
In children, parasitic infections are a particularly common cause, especially in endemic areas or in cases of international travel.
Clinical Presentation
The clinical presentation of Löffler's syndrome can vary, but typically includes:
- Dry cough
- Dyspnea
- Wheezing
- Low-grade fever
- Fatigue
- Chest pain
- Hemoptysis (rare)
In some cases, patients may be asymptomatic, with the condition discovered incidentally on chest imaging.
Diagnosis
Diagnosis of Löffler's syndrome involves a combination of clinical presentation, laboratory findings, and imaging studies:
- Blood tests: Elevated eosinophil count (>1500 cells/µL)
- Chest X-ray: Transient, migratory pulmonary infiltrates
- CT scan: Ground-glass opacities, consolidations
- Bronchoscopy with bronchoalveolar lavage (BAL): Increased eosinophils in BAL fluid
- Lung biopsy (rarely necessary): Eosinophilic infiltration of lung tissue
Additional tests may be performed to identify underlying causes, such as stool examination for parasites or allergy tests.
Treatment
Treatment of Löffler's syndrome depends on the underlying cause and severity of symptoms:
- Mild cases: Often self-limiting and may resolve without specific treatment
- Parasitic infections: Appropriate antiparasitic medications (e.g., albendazole, ivermectin)
- Drug-induced cases: Discontinuation of the offending medication
- Symptomatic treatment: Bronchodilators, oxygen therapy if needed
- Corticosteroids: For severe or persistent symptoms, prednisone may be prescribed
In pediatric cases, close monitoring and appropriate dosing of medications are crucial.
Prognosis
The prognosis for Löffler's syndrome is generally good:
- Most cases resolve spontaneously within 2-4 weeks
- Recurrence is uncommon but possible, especially if the underlying cause is not addressed
- Chronic or recurrent cases may require long-term management
- Complications are rare but can include respiratory failure in severe cases
Regular follow-up is recommended to ensure complete resolution and to monitor for any potential complications or recurrences.
