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Original Research: DIFFUSE LUNG DISEASE |

Fraction of Exhaled Nitric Oxide in Patients With Acute Eosinophilic PneumoniaAcute Eosinophilic Pneumonia

Ji Eun Lee, MD; Chin Kook Rhee, MD; Ji Hwan Lim, MD; Sang Min Lee, MD; Young Soo Shim, MD, FCCP; Choon-Taek Lee, MD; Sei Won Lee, MD
Author and Funding Information

From the Department of Internal Medicine (Drs J. E. Lee, Rhee, Lim, S. M. Lee, and Shim), The Armed Forces Capital Hospital; the Division of Pulmonology and Critical Care Medicine (Drs C.-T. Lee and S. W. Lee), Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam; and the Department of Pulmonary and Critical Care Medicine (Dr S. W. Lee), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Correspondence to: Sei Won Lee, MD, Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Pungnap 2-dong, Songpa-gu, Seoul, 138-783, Republic of Korea; e-mail: seiwon@amc.seoul.kr


Funding/Support: This study was supported by a grant from the Korean Health Technology R&D project, Ministry for Health, Welfare & Family Affairs, Republic of Korea [A100808].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2012 American College of Chest Physicians


Chest. 2012;141(5):1267-1272. doi:10.1378/chest.11-1303
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Background:  Acute eosinophilic pneumonia (AEP) is an idiopathic disease characterized by pulmonary eosinophilia. Because the fraction of exhaled nitric oxide (Feno) is a surrogate of eosinophilic inflammation, we evaluated the levels, changed treatments, and the diagnostic role of Feno in patients with AEP.

Methods:  Between June 2010 and March 2011, we prospectively enrolled patients at the Armed Forces Capital Hospital who had pulmonary infiltrates and a febrile illness and who were clinically suspected to have AEP. We measured Feno twice at the initial visit (pretreatment) and 2 weeks after the initial measurement (posttreatment).

Results:  A total of 60 subjects were enrolled, and 31 were given a diagnosis of AEP. The pretreatment Feno levels of the patients with AEP were significantly higher than those of the patients without AEP (median, 48 parts per billion [ppb] [range, 10-138] vs 14 ppb [range, 5-41]; P < .001). The cut-off value (23.5 ppb) showed that the maximal area under the receiver operating characteristic curve predicted AEP with a sensitivity of 0.87 and a specificity of 0.83. The posttreatment Feno levels decreased significantly in the patients with AEP, and the levels were similar to the patients without AEP (median, 19 ppb [range, 7-44] vs 14 ppb [range, 1-58]; P = .21)

Conclusions:  The Feno level was significantly higher in patients with AEP than in those without AEP. Feno measurement can be used as a diagnostic tool to differentiate patients with AEP from those without AEP.

Trial Registry:  ClinicalTrials.gov; No.: NCT01152424; URL: www.clinicaltrials.gov

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