PMID: 9176582Mar 1, 1997Paper

Cor pulmonale: an unusual presentation of tropical eosinophilia

Annals of Tropical Paediatrics
B S QuahR A Pennie

Abstract

Tropical pulmonary eosinophilia (TPE) is considered to be a variant of human filarial infection. The pulmonary manifestations of TPE have been well described. Extra-pulmonary features of the disease, although not commonly seen, have been reported previously. A 9-year-old Malay girl with a history of recurrent cough and wheezing was admitted because of cardiac failure. Physical examination revealed a very sick girl with tachypnoea, central cyanosis, finger clubbing, elevated jugular venous pulse, generalized crackles and rhonchi in the chest, a loud second heart sound and hepatosplenomegaly. A chest radiograph showed cardiomegaly and right pleural effusion. Laboratory investigations revealed hypochromic, microcytic anaemia with persistent blood eosinophilia (absolute eosinophil counts varied from 1.9 to 5.5 x 10(9)/1). The ELISA test for antifilarial IgG antibodies was strongly positive. She responded promptly to treatment with diethylcarbamazine. In summary, this is a patient with TPE who presented with cor pulmonale, probably due to late-stage interstitial pulmonary fibrosis. In order to prevent the long term morbidity of cardiorespiratory disability, the early signs of TPE should be recognized and the infection treated.

References

Jan 1, 1991·Respiration; International Review of Thoracic Diseases·V K VijayanR Prabhakar
May 1, 1985·The American Journal of Tropical Medicine and Hygiene·J S Boornazian, M J Fagan
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Jan 1, 1993·Respiratory Medicine·F E Udwadia
Sep 1, 1961·British Heart Journal·R J VAKIL
Nov 1, 1964·Thorax·F E UDWADIA, V V JOSHI

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