D2.159 - Idiopathic Chronic Eosinophilic Pneumonia: A Case Series

Idiopathic Chronic Eosinophilic Pneumonia (ICEP) is a rare disease classified among diffuse parenchymal lung diseases. Due to the limited data regarding treatment outcomes in ICEP, we present the results of eleven patients followed in our clinic.

The demographic and clinical characteristics of eleven patients diagnosed with ICEP in our clinic between 2016 and 2025 were evaluated.

The diagnostic criteria for ICEP included the presence of symptoms lasting ≥15 days, compatible pulmonary parenchymal abnormalities on chest radiography or computed tomography (CT), eosinophilia in peripheral blood and/or bronchoalveolar lavage (BAL), exclusion of other known causes, and clinical and radiological improvement with corticosteroid therapy. 

The female-to-male ratio was 7/4, and the median age was 45 years (range: 20–73 years). All patients presented with dyspnea at admission. Regarding other presenting symptoms, cough was observed in 72.7% of patients (8/11), sputum production in 18.1% (2/11), and fever in 27.2% (3/11). On computed tomography (CT), peripheral or diffuse ground-glass opacities were observed in 90.9% of patients, ground-glass nodules in 45.4%, and focal areas of consolidation/consolidation in 36.3%. Ten patients (90.9%) had a history of asthma, and one patient (0.9%) was diagnosed with asthma concurrently with the diagnosis of ICEP. The median eosinophil count at diagnosis was 3.510 cells/µL (minimum–maximum: 2.640–9.970). All patients received initial treatment with methylprednisolone at a dose of 0.5 mg/kg. Mepolizumab was added in six patients due to concomitant severe eosinophilic asthma. The mean duration of mepolizumab use was 43.6 months (range: 12–81 months). None of the six patients receiving mepolizumab experienced ICEP relapse or required systemic corticosteroid therapy.

Although evidence supporting the use of biologic therapies in ICEP remains limited, our findings suggest that mepolizumab  may represent a valuable therapeutic alternative in selected patients, particularly those with steroid dependence, recurrent disease, or contraindications to systemic corticosteroids. Further well-designed, large-scale prospective studies are warranted to clarify the efficacy and long-term safety of biologic treatments in ICEP.