Indian Journal of Respiratory Care

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VOLUME 11 , ISSUE 2 ( April-June, 2022 ) > List of Articles

Original Article

Clinicodemographic Profile of Tropical Pulmonary Eosinophilia in a Tertiary Care Institute of Bihar

Manish Shankar, Md Arshad Ejazi, Satyadeo Choubey, Dinesh Kumar

Keywords : Absolute eosinophil count, filarial antigen, immunoglobulin E, tropical pulmonary eosinophilia

Citation Information : Shankar M, Ejazi MA, Choubey S, Kumar D. Clinicodemographic Profile of Tropical Pulmonary Eosinophilia in a Tertiary Care Institute of Bihar. Indian J Respir Care 2022; 11 (2):112-116.

DOI: 10.4103/ijrc.ijrc_138_21

License: CC BY-NC-SA 4.0

Published Online: 06-12-2022

Copyright Statement:  Copyright © 2022; Indian Journal of Respiratory Care.


Background: Tropical pulmonary eosinophilia (TPE) is a type of eosinophilic lung disease, and it is associated with a hypersensitivity response to Wuchereria bancrofti and Brugia malayi's microfilariae. Any systemic data regarding its clinical, demographic, and radiological profile in patients of this part of the world are sparse. This study aimed to study the clinical and demographic profile of TPE patients in this geographical area. Materials and Methods: This is a prospective observational study done over 1 year period in patients with TPE-like features in a tertiary care center of Bihar. After appropriate clinical and blood examination, absolute eosinophil count (AEC), serum total immunoglobulin E (IgE), spirometry, filarial antigen, and filarial antibody and chest radiology were done. Results: Among 77 cases of TPE, 54 were male (70.1%) and 23 were female (29.9%), in a ratio of 2.35:1. The majority of cases 43 (55.9%) were found in age less than 30 years. Most of our participants were students 28 (36.4%), homemakers 19 (24.7%), and farmers 17 (22.1%). The most common clinical feature was cough 77 (100%). Filarial antibody was raised in all (100%) while antigen was positive in 96.1%. Chest radiology was normal in 71.4%. Mean AEC and IgE ± standard deviation were 6730.71 + 4671.12 and 7983.14 ± 7279.60 kU/L, respectively. Spirometric findings were mild restriction 25 (32.5%). Conclusion: The prevalence of TPE is supposed to be higher in endemic areas. The patient should be evaluated in detail if having raised eosinophil count (>3000/mm3) with increased IgE level (>1000 kU/L) along with suggestive clinical features. Timely diagnosis and treatment can cure the disease and prevent its complications.

  1. World Health Organization. Lymphatic filariasis: The disease and its control. Fifth report of the WHO Expert Committee on Filariasis. World Health Organ Tech Rep Ser 1992;821:1-71.
  2. World Health Organization. Lymphatic filariasis: Diagnosis and pathogenesis. WHO expert committee on filariasis. Bull World Health Organ 1993;71:135-41.
  3. Michael E, Bundy DA. Global mapping of lymphatic filariasis. Parasitol Today 1997;13:472-6.
  4. Udwadia FE. Herzog H, editor. Tropical eosinophilia. In: Pulmonary Eosinophilia: Progress in Pulmonary Research. Vol. 7. Basel: S Karger;
  5. p. 35-155.
  6. Viswanathan R, Prasad M, Prasad S, Saran R, Sinha TR, Sinha SP. Morbidity survey of jail population. I. Incidence of certain chronic respiratory diseases, with special reference to pulmonary eosinophilosis. Indian J Chest Dis 1965;7:142-5.
  7. Ray D, Abel R, Selvaraj KG. Epidemiology of pulmonary eosinophilia in rural south India - A prospective study, 1981-86. J Epidemiol Community Health 1993;47:469-74.
  8. Weingarten RJ. Tropical eosinophilia. Lancet 1943;1:103-5.
  9. Islam N, Haq AQ. Eosinophilic lung abscess - A new entity. Br Med J 1962;1:1810-1.
  10. Dreyer G, Dreyer P, Piessens WF. Extralymphatic disease due to bancroftian filariasis. Braz J Med Biol Res 1999;32:1467-72.
  11. Vijayan VK. Immunopathogenesis and treatment of eosinophilic lung diseases in the tropics. In: Sharma OP, editor. Lung Biology in Health and Disease: Tropical Lung Disease. 2nd ed. New York: Taylor and Francis; 2006. p. 195-239.
  12. Ong RK, Doyle RL. Tropical pulmonary eosinophilia. Chest 1998;113:1673-9.
  13. Ottesen EA, Nutman TB. Tropical pulmonary eosinophilia. Annu Rev Med 1992;43:417-24.
  14. Neva FA, Ottesen EA. Tropical (filarial) eosinophilia. N Engl J Med 1978;298:1129-31.
  15. Ottesen EA. Immunological aspects of lymphatic filariasis and onchocerciasis in man. Trans R Soc Trop Med Hyg 1984;78 Suppl:
  16. Spry CJ, Kumaraswami V. Tropical eosinophilia. Semin Hematol 1982;19:107-15.
  17. Islam N, Huque KS. Radiological features of tropical eosinophilia. J Trop Med Hyg 1965;68:177-80.
  18. Khoo FY, Danaraj TJ. The roentgenographic appearance of eosinophilic lung (tropical eosinophilia). Am J Roentgenol Radium Ther Nucl Med 1960;83:251-9.
  19. Sandhu M, Mukhopadhyay S, Sharma SK. Tropical pulmonary eosinophilia: A comparative evaluation of plain chest radiography and computed tomography. Australas Radiol 1996;40:32-7.
  20. Vijayan V, Kuppurao KV, Venkatesan P, Sankaran K, Prabhakar R. Pulmonary membrane diffusing capacity and capillary blood volume in tropical eosinophilia. Chest 1990;97:1386-9.
  21. Kumar R, Mourya S. Pulmonary function test in tropical pulmonary eosinophilia. Int J Med Res Rev 2014;2:283-90.
  22. Vijayan VK, Kuppu Rao KV, Sankaran K, Venkatesan P, Prabhakar R. Diffusing capacity in acute untreated tropical eosinophilia. Indian J Chest Dis Allied Sci 1988;30:71-7.
  23. Rom WN, Vijayan VK, Cornelius MJ, Kumaraswami V, Prabhakar R, Ottesen EA, et al. Persistent lower respiratory tract inflammation associated with interstitial lung disease in patients with tropical pulmonary eosinophilia following conventional treatment with diethylcarbamazine. Am Rev Respir Dis 1990;142:1088-92.
  24. Vijayan VK, Rao KV, Sankaran K, Venkatesan P, Prabhakar R. Tropical eosinophilia: Clinical and physiological response to diethylcarbamazine. Respir Med 1991;85:17-20.
  25. Sharma SK, Pande JN, Khilnani GC, Verma K, Khanna M. Immunologic & pulmonary function abnormalities in tropical pulmonary eosinophilia. Indian J Med Res 1995;101:98-102.
  26. Angirish B, Jankharia B, Sanghavi P. The role of HRCT in tropical pulmonary eosinophilia. Eur J Radiol 2020;131:109207.
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