Introduction
Tropical pulmonary eosinophilia (TPE) is a syndrome that results from an immunologic hyperresponsiveness to filarial parasites, Wuchereria bancrofti and Brugia malayi, and is characterized by cough, dyspnoea and nocturnal wheezing, diffuse reticulonodular infiltrates in chest radiographs and marked peripheral blood eosinophilia(1, 2). This clinical entity is primarily described among men between 15-40 years of age(2, 3). We report two children less than 10 years of age who reported with symptoms of asthma and were later confirmed to have TPE.
Case Report
Discussion
Over the past five to six decades, there have been reports of peripheral blood eosinophilia associated with respiratory symptoms resembling bronchial asthma. These clinical
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Most patients show marked symptomatic and radiographic improvement 1 month after the start of treatment, and significant improvement in almost all. aspects of lung function. There is an incomplete reversal of clinical, hematological, radiological and physiological changes in TPE after treatment, however. Most patients show improvement after a standard 3 weeks of DEC therapy, but many are left with chronic respiratory tract inflammation and a mild form of interstitial lung disease. Relapses occur in 20% of patients followed-up for 5 years. The persistent mild interstitial lung disease and the high relapse rates in TPE have suggested that repeated monthly courses of DEC at 2 – 3 monthly intervals for a period of 1–2 years may be useful. As steroids were found to be effective in the treatment of TPE, a controlled clinical trial is needed to establish the optimum dose and duration of DEC therapy (with or without steroids), and to prevent the development of interstitial lung disease(2,