Pulmonary Infiltration Associated with Blood Eosinophilia (P.I.E.): A Clinical Study of Loeffler's Syndrome and of Periarteritis Nodosa with P.I.E. Syndrome

¹ Section of Medicine

The problem of pulmonary infiltrations with blood eosinophilia has been reviewed. A clinical study was made of 30 patients in whom a diagnosis of Loeffier's syndrome was thought to be established on clinical grounds, and of 13 patients in whom a diagnosis of periarteritis nodosa with the syndrome of pulmonary infiltration associated with eosinophilia (P.I.E.) was established by microscopic means. A history of bronchial asthma extending over several years and the occurrence of more than one attack of pulmonary infiltration and eosinophilia are more in keeping with Loeffier's syndrome. The longer the attack of the P.I.E. syndrome, especially if it is the first known attack, the more likely is the disease to be periarteritis nodosa. Hemoptysis is more common with the latter, and evidence of multiple-system involvement is conclusive. This may be shown by purpuric lesions, mononeuritis multiplex, arthritic symptoms and uremia. If the patient appears gravely ill and is pursuing a steadily downhill course, then Loeffler's syndrome is almost surely excluded.