Löffler syndrome is a rare pulmonary condition characterized by transient lung infiltrates and eosinophilia. It is commonly associated with parasitic infections, particularly helminths, and presents with respiratory symptoms that usually resolve without specific treatment. Understanding its etiology, clinical presentation, and management is crucial for effective diagnosis and care.
Causes and Risk Factors
Löffler syndrome is primarily linked to parasitic infections, but other factors can also contribute:
1. Parasitic Infections
- Ascaris lumbricoides (roundworm)
- Strongyloides stercoralis
- Ancylostoma duodenale and Necator americanus (hookworms)
- Toxocara canis (dog roundworm)
2. Drug Reactions and Allergies
- Certain medications, including antibiotics and nonsteroidal anti-inflammatory drugs (NSAIDs), may trigger eosinophilic lung reactions.
3. Environmental and Occupational Exposures
- Exposure to allergens, fungal spores, or toxic substances can cause eosinophilic pneumonia.
Pathophysiology
The syndrome develops when eosinophils, a type of white blood cell, accumulate in the lungs in response to parasitic migration or allergic reactions. The presence of eosinophils causes inflammation, leading to transient pulmonary infiltrates.
Clinical Symptoms
Patients with Löffler syndrome may present with mild to moderate respiratory symptoms:
- Cough (often dry or mildly productive)
- Shortness of breath (dyspnea)
- Wheezing
- Fever (rare in uncomplicated cases)
- Fatigue and malaise
- Mild chest discomfort
Diagnosis
A combination of clinical history, imaging, and laboratory tests helps confirm the diagnosis.
1. Blood Tests
- Eosinophilia: Elevated eosinophil count (>500 cells/µL)
- Serology for parasitic infections
2. Imaging Studies
- Chest X-ray: Patchy, migratory infiltrates
- CT Scan: More detailed assessment of lung abnormalities
3. Stool Examination
- Detection of helminthic eggs or larvae
4. Bronchoalveolar Lavage (Rarely Required)
- To analyze eosinophil presence in lung secretions
Treatment and Management
Löffler syndrome is usually self-limiting, but specific treatment may be needed in persistent cases.
1. Supportive Care
- Symptomatic management with bronchodilators for wheezing
- Hydration and rest
2. Antiparasitic Therapy
- Albendazole or Mebendazole for roundworm infections
- Ivermectin for Strongyloides stercoralis
3. Corticosteroids (In Severe Cases)
- Used when significant respiratory distress occurs
Prognosis and Prevention
- The condition resolves within 2-4 weeks in most cases.
- Preventative measures include improved hygiene, proper food handling, and deworming programs in endemic areas.
Löffler syndrome is a transient, eosinophilic lung disease commonly linked to parasitic infections. While often self-limiting, early diagnosis and appropriate treatment are essential for symptom relief and prevention of complications.
