ABSTRACT
This chapter reviews the mechanism of drug-induced eosinophilia, medications commonly causing drug-induced eosinophilic lung disease, the spectrum of clinical presentation, the management of eosinophilic lung disease, and long-term complications of drug-induced eosinophilic lung disease. Drug-induced eosinophilic lung disease can have several different clinical presentations including simple pulmonary eosinophilia, chronic eosinophilic pneumonia, acute eosinophilic pneumonia, and Churg–Strauss syndrome. Chronic eosinophilic pneumonia presents with weeks or months of progressive respiratory symptoms, diffuse or peripheral radiographic infiltrates, and increased blood eosinophils. Laboratory evaluation is rarely diagnostic for drug-induced eosinophilic lung disease but may be useful to diagnose other diseases in the differential diagnosis. Two epidemics of drug-induced eosinophilic lung disease warrant special mention because of their historical significance: the eosinophilia–myalgia syndrome and the ‘toxic oil’ syndrome. Common patterns of clinical presentation include simple pulmonary eosinophilia, chronic eosinophilic pneumonia and acute eosinophilic pneumonia.
