Tohoku J. Exp. Med., 2009, 219(3)

Emergency Cesarean Section as a Result of Acute Eosinophilic Pneumonia during Pregnancy

YASUSHI KOTANI,1 MITSURU SHIOTA,1 MASAHIKO UMEMOTO,1 HIDEKATSU NAKAI,1 TAKAKO TOBIUME,1 HIROMITSU TSURITANI,1 MASAO SHIMAOKA,1 KUNIHIKO DOH1 and HIROSHI HOSHIAI1

1Department of Obstetrics and Gynecology, Kinki University School of Medicine, Osaka, Japan

Acute eosinophilic pneumonia is a disease of unknown etiology characterized by peripheral blood eosinophilia and pulmonary infiltrative shadows on radiography. Acute eosinophilic pneumonia follows an acute course within 1 week and the symptoms include fever, dyspnea, and cough. Acute eosinophilic pneumonia has a good prognosis and responds promptly to steroid treatments. Here we present a critical case of acute eosinophilic pneumonia during pregnancy, which led to emergency cesarean section because of fetal distress. The patient was a 24-year-old gravida at 34 + 6 weeks gestation, with fever, and an elevated CRP; thus antibiotics were started. At 35 + 1 weeks gestation, cardiotocography (CTG) revealed late decelerations, fetal distress was diagnosed, and an emergency cesarean section was performed. The pre-operative maternal blood gas analysis showed a low PaO2 of 55.7 mmHg and a chest X-ray revealed ground-glass opacities and pleural effusions in the middle lower lung fields bilaterally. A male of 2,336 g in weight was delivered with Apgar scores of 8 and 8 at 1 and 5 min, respectively. Due to the clinical progress and the elevated eosinophil count (532/μl) in the peripheral blood differential leukocyte count, the diagnosis of acute eosinophilic pneumonia was made. With the administration of oxygen and steroid treatment, the patient's general condition recovered. Both the mother and the baby were discharged on the 10th post-operative day and the patient has been leading a normal life with no recurrence for > 3 years since delivery.

keywords —— acute eosinophilic pneumonia; pregnancy; cesarean section; fetal distress; steroid treatment.

© 2009 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2009, 219, 251-255

Corresspondence: Yasushi Kotani, Department of Obstetrics and Gynecology, Kinki University School of Medicine, 377-2 Ohno-higashi, Osaka-sayama, Osaka, 589-8511, Japan.

e-mail: y-kotani@sanfu.med.kindai.ac.jp