Idiopathic Acute Eosinophilic Pneumonia with Thromboembolic Complications in a 16-year-old Child

Idiopathic acute eosinophilic pneumonia (IAEP) was first described in 1989 by Allen et al. and Badesch et al., there had been approximately 100 cases reported since then. By definition, IAEP belongs to the category of pulmonary eosinophilia. The most common presenting symptoms are fever, cough and dyspnea. Therefore, these clinical manifestations do closely resemble acute respiratory distress syndrome (ARDS) or pneumonia. Usually, the treatment of choice is systemic corticosteroid, often recover without significant morbidities or mortalities. Here we present a 16-year-old male with IAEP with a complication of pulmonary embolism and deep vein thrombosis during the course of his corticosteroid treatment. The thromboembolic event was most likely caused by an eosinophil-derived protein called major basic protein (MBP), which could induce a hypercoagulative state. We suggest that pediatric pulmonologists should bear in mind that eosinophilia is a pro-thrombotic factor, and that potential thromboembolism could occur.