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June 1979

Loeffler's Syndrome?

Arch Dermatol. 1979;115(6):677. doi:10.1001/archderm.1979.04010060003010

To the Editor.—  Drs Guill and Odom have recently described two interesting patients with cutaneous larva migrans, eosinophilia, and pulmonary infiltration (Arch Dermatol 114:1525-1526, 1978); however, neither patient had Loeffler's syndrome.The eosinophilic pneumonias may be classified into one of five categories1,2: (1) Loeffler's syndrome, (2) chronic eosinophilic pneumonia (Carrington's), (3) pulmonary eosinophilia with asthma, (4) tropical eosinophilia (Weingarten's disease), or (5) periarteritis nodosa. Drs Guill and Odom describe two patients with an eight-week course of nonproductive cough, chest tightness, exertional dyspnea, and chest roentgenograms showing pulmonary infiltrates (peripheral, patchy), accompanying eosinophilia and classical cutaneous larva migrans. Unfortunately, sputum was not obtainable nor pulmonary function testing, PPD, cold agglutinins, or filarial complement fixation tests reported.Loeffler's syndrome1,2 is by definition an essentially asymptomatic disease (in one series3 only five of 28 patients experienced cough, the most common symptom) with transient eosinophilia (peaks within four days of chest

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