Table 1. Literature overview: cases of Löffler syndrome.

Article

Clinical picture

Diagnostic tests

Treatment

Outcome

Del Giudice et al. (2002)

Intense non-productive cough

Lab: 10% eosinophils, normal IgE
RI: ill-defined pulmonal reticulonodular infiltrates
BAL: eosinophilic alveolitis
Serology: negative

Stool culture: negative

Oral thiabendazole 25 mg/kg twice daily for 10 days; oral corticosteroids 1 mg/kg daily

After 5 days: normalized peripheral eosinophilia and symptoms.

Lee et al. (2003)

No pulmonary symptoms

Lab: 35% eosinophils, serum IgE 1020

IU/mL, clonorchis specific IgG 0.27.

RI: solitary pulmonary nodule, migrating nodular densities

BAL: 25% eosinophils
Sputum cytology: eosinophilia
Stool examination: clonorchis sinensis eggs
Lung biopsy: eosinophilic infiltration
Bronchoscopy: normal

Oral praziquantel

Normalized peripheral eosinophilia. No signs of recurrence after 1 year follow-up.

Sator et al. (2007)

Cough and dyspnea

Lab: 33% eosinophils
RI: local pulmonal infiltrate
BAL: 79% eosinophils
Serology: negative
Stool and sputum examination: negative

Bronchoscopy: normal

Oral methylprednisolone 40 mg daily, in decreasing dosage

Normalized peripheral eosinophila and cleared chest X-rays after 6 months. One month later, recurrence of symptoms and patient eventually died of another condition.

Meta-Jevtovic et al. (2008)

Low grade fever, shortness of breath, cough and reduced exercise tolerance

Lab: eosinophilia

RI: pulmonary eosinophilic infiltrates
Lung biopsy: changes associated with Löffler’s syndrome

Oral corticosteroids

Marked improvement of symptoms.

Turhan et al. (2008)

Headache, sore throat, cough

Lab: 14% eosinophils
Stool examination: Strongyloides stercoralis

Oral albendazole

Improvement of symptoms and negative stool examinations .

Schaub et al. (2002)

No pulmonary symptoms

Lab: eosinophilia

RI: migratory pulmonary infiltrates

Oral albendazole 400 mg on 5 consecutive days and a single dose of oral praziquantel 3600 mg

Resolved peripheral eosinophilia and pulmonary infiltrates

Tokojima et al. (2004)

High fever and fatigue

Lab: increased IgE level, no eosinophilia

RI: ‘ground glass opacities’ in the right lung field
BAL: high proportion of eosinophils
ELISA: Ascaris suum

Oral albendazole

Clearance of symptoms

Tan et al. (2010)

Dyspnea, wheezing and chest discomfort

Lab: Leucocytosis, 19.1% eosinophils

Blood gas: hypoxemia

RI: reticulonodular pulmonary infiltrates

Echocardiogram: normal

Stools: negative

Oral mebendazole

Oral albendazole

Intravenous hydrocortisone

Oxygen supplementation

Complete remission

 


 

Lab:                      laboratory investigations
RI:                         radiologic investigations
BAL:                     bronchoalveolar lavage
ELISA:                 enzyme-linked immunoabsorbent assay)