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               Tropical Pulmonary Eosinophilia






If you live in Bihar, Uttar Pradesh, West Bengal, Assam, Kerala and Tamil Nadu doctors would first rule out this easily. treatable condition before thinking of other disease like tuberculosis and asthma. Tropical Eosinophilia is more common in these states because of higher incidence of filiariasis. in these region. Tropical Eosinophilia is considered a manifestation of a specific of microfilaria.

Some children with these disease may also have enlargement of glands in the neck and elsewhere. Others may cough up a little blood. The child may also have wheeze.

Introduction

Tropical Pulmonary Eosinophilia (T.P.E) was first described in 1940 by Weingarten in India.  It is transmitted through  a bite of mosquito.


Tropical eosinophilia, or (TPE), is caused by Wuchereria bancrofti, a filarial infection. . Tropical eosinophilia is considered a manifestation of a species of microfilaria

This is a disease that can be confused with tuberculosis, asthma and cough related to roundworm.

Where is filaria more common?
It is most common in tropical Africa and south east Asia.




Trend and present endemicity of the filariasis in India
State of Bihar has highest endemicity (over 17%) followed by Kerala (15.7%) and Uttar Pradesh (14.6%). ... B malayi nocturnal periodic infection is prevalent in the states of Kerala, Tamil Nadu, Andhra Pradesh, Orissa, Madhya Pradesh, Assam and West Bengal.


Life cycle






Symptoms

  • Persistent or recurrent cough that gets aggravated at night, weakness, loss of weight and low fever raises the possible diagnosis of this disease.
  • Malaise, anorexia,
  • Paroxysmal dry cough, Asthmatic attack and a large spleen
  • Dyspnea or wheezing.
  • Marked peripheral blood Eosinophilia.
  • Spontaneous resolution over several weeks.


Diagnosis

  • History of residence in the area endemic for lymphatic filariasis.
  • Absolute eosinophil count : Peripheral Blood Smear : Peripheral blood eosinophilia of > 3000/mm raised to 3




  • Elevated serum IgE level of >1000 IU/ml.
  • Increased Anti filaria antibody titers.
  • Absence of detectable microfilaria in peripheral blood.
  • Dramatic response to Diethylcarbamazine almost confirms the diagnosis.
  • Chest X-ray : Typical
      
Diminished Translucency
                                              


Children having roundworms may also have a similar sort of cough. But in all conditions that resembles tropical eosinophilia, the absolute eosinophil count is not so high.


Treatment
  • Tab Banocide forte or Tab Hetrazen 100 mg. One tab thrice a day for one month. Repeat three such courses at monthly intervals
  • Phensedyl lintus. one teaspoonful morning and night
  • Note Diethlycarbamazine may cause exacerbation of symptoms in the early stages, if so
  • Tab Prednesolone 5 mg1-1-1-1- for 10 days.



https://madhuchhandacdmo.blogspot.com/2021/03/eosinophilia-diminished-

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