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Review
. 2023 Nov;58(11):3023-3031.
doi: 10.1002/ppul.26650. Epub 2023 Aug 22.

Eosinophilic plastic bronchitis: Case series and review of the literature

Alexander I Gipsman  1 , Lance Feld  1 , Brandy Johnson  1 , Joshua P Needleman  2 , Heather Boas  1 , Nancy Lin  1   3 , Brittany DePasquale  4 , Jennifer Pogoriler  3   5 , Karen M McDowell  6 , Joseph C Piccione  1   3
Affiliations
Review

Eosinophilic plastic bronchitis: Case series and review of the literature

Alexander I Gipsman et al. Pediatr Pulmonol. 2023 Nov.

Abstract

Plastic bronchitis is a term used to describe group of life-threatening disorders characterized by the presence of large obstructing casts in the airways. Eosinophilic plastic bronchitis is a subtype of plastic bronchitis that occurs mainly in children and has not been well-described in the literature. Patients may have a history of asthma or atopy, but many do not. They often present with cough and wheezing, and frequently have complete collapse of one lung seen on imaging. The severity of presentation varies depending on the location of the casts, ranging from mild symptoms to severe airway obstruction and death. Bronchoscopy is often required to both diagnose and treat this condition. A variety of medical therapies have been used, although no formal studies have evaluated their efficacy. Symptoms may resolve after initial cast removal, but in some patients, cast formation recurs. Here, we report a case series of nine patients with eosinophilic plastic bronchitis and review the existing literature of this condition.

Keywords: Charcot−Leyden crystals; asthma; asthma & early wheeze; bronchoscopy; cryoextraction; mucus disorders; plastic bronchitis; pulmonology (general).

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Conflict of interest statement

CONFLICT OF INTEREST STATEMENT

The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Endobronchial biopsy from Patient 1. Pathology reveals subepithelial eosinophils (*) and few scattered eosinophils in the overlying epithelium (arrow).
FIGURE 2
FIGURE 2
Bronchial cast obstructing the left mainstem bronchus as seen on (A) chest X-ray, (B) CT scan, and (C, D) bronchoscopy.
FIGURE 3
FIGURE 3
Histopathology of bronchial cast with degenerating eosinophils admixed with Charcot–Leyden crystals.
See this image and copyright information in PMC

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