RESUMEN
Background: The potential link between alopecia areata (AA) and eosinophilia is unclear, as well as its clinical manifestations in these patients' subsets. Methods: This is a monocentric retrospective observational study in which clinical and laboratory data were summarized and evaluated the AA subset with concurrent eosinophilia. Results: In a sample of 205 AA patients, 38 (18.5%) were classified as AA with eosinophilia. Interestingly, this subset of patients had a statistically higher prevalence of atopia and nail abnormalities (p < 0.05) than AA without eosinophilia. AA patients with eosinophilia had a 3.70 higher odds of more severe hair loss versus age- and gender-matched AA without eosinophilia. Conclusions: AA patients with eosinophilia had distinctive clinical and laboratory characteristics, so future studies may potentially explore the use of IL-5 inhibitors.
Asunto(s)
Alopecia Areata , Eosinofilia , Humanos , Alopecia Areata/epidemiología , Femenino , Masculino , Adulto , Eosinofilia/epidemiología , Prevalencia , Estudios Retrospectivos , Persona de Mediana Edad , Uñas/patología , Uñas Malformadas/epidemiología , Índice de Severidad de la Enfermedad , Adolescente , Adulto JovenAsunto(s)
Encefalitis , Eosinofilia , Meningitis , Infecciones por Strongylida , Humanos , Meningitis/líquido cefalorraquídeo , Meningitis/diagnóstico por imagen , Infecciones por Strongylida/líquido cefalorraquídeo , Infecciones por Strongylida/complicaciones , Encefalitis/líquido cefalorraquídeo , Encefalitis/diagnóstico por imagen , Eosinofilia/líquido cefalorraquídeo , Animales , Masculino , Imagen por Resonancia Magnética , Angiostrongylus cantonensis , FemeninoRESUMEN
The aim of this study was to investigate all-cause mortality rates and related factors in patients with different levels of eosinophilia. This retrospective cohort study was conducted between January 2020 and December 2022 in the Internal Medicine Department of Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkiye. A total of 161 patients with eosinophilia (at least 3 times) were included and divided into groups with absolute eosinophil counts of 500-999/µL (mild), 1000-1500/µL (moderate), and >1500/µL (severe). The mean age of patients was 65.67â ±â 16.64 years at the time of admission, and 45 patients (57.8%) were male. The rates of mortality, oncological disease, and organ involvement were significantly higher in the severe group (Pâ <â .05). Increased serum total immunoglobulin E and vitamin B12, hematocrit value, eosinophil-to-lymphocyte ratio, and leukocyte were observed in eosinophilic patients. Decreased lymphocyte count, hemoglobin and hematocrit values were higher in deceased patients than in survivors (Pâ <â .05). Increased eosinophil-to-lymphocyte ratio, C-reactive protein, vitamin B12, and lactate dehydrogenase (LDH) activity were observed in participants who died compared to those who survived (Pâ <â .05). Multivariable logistic regression revealed that advanced age and higher LDH activity were independently associated with greater mortality risk while receiving non-steroid anti-inflammatory drugs or proton-pump inhibitors were associated with reduced mortality risk (Pâ <â .05). Advanced age and increased LDH activity were independently associated with greater risk for mortality, whereas absolute eosinophil counts was not. Considering the literature on this topic, our results show the need for further clinical and fundamental research to understand the role of eosinophils in human disease.
Asunto(s)
Eosinofilia , Humanos , Masculino , Femenino , Eosinofilia/mortalidad , Eosinofilia/sangre , Estudios Retrospectivos , Anciano , Persona de Mediana Edad , Anciano de 80 o más Años , Turquía/epidemiología , Recuento de Leucocitos , Eosinófilos , Factores de Riesgo , Adulto , Índice de Severidad de la Enfermedad , Causas de MuerteRESUMEN
Nonepisodic angioedema with eosinophilia (NEAE) is characterised by a single episode of angioedema localised to the extremities and peripheral eosinophilia. While NEAE can develop in response to infection or vaccination, NEAE associated with acute parvovirus B19 (B19V) infection is rare. We describe the case of a young woman with NEAE that developed during acute B19V infection. She presented with 1-week history of pruritus and polyarthralgia in the extremities, followed by the development of peripheral oedema, and was positive for anti-B19V IgM antibody. Her arthralgia improved within 2 weeks without any specific intervention; however, the oedema and pruritic erythema persisted and the peripheral eosinophil count increased. A short course of prednisolone therapy for suspected NEAE alleviated the symptoms, which have not recurred for more than 2 years. Thus, we believe that the patient was affected by NEAE and that NEAE can develop following acute B19 infection.
Asunto(s)
Angioedema , Eosinofilia , Parvovirus B19 Humano , Humanos , Femenino , Parvovirus B19 Humano/inmunología , Angioedema/tratamiento farmacológico , Angioedema/virología , Angioedema/diagnóstico , Eosinofilia/tratamiento farmacológico , Eosinofilia/virología , Eosinofilia/complicaciones , Prednisolona/uso terapéutico , Adulto , Eritema Infeccioso/complicaciones , Eritema Infeccioso/diagnóstico , Infecciones por Parvoviridae/complicaciones , Infecciones por Parvoviridae/diagnóstico , Infecciones por Parvoviridae/tratamiento farmacológico , Artralgia/etiología , Artralgia/virología , Enfermedad AgudaRESUMEN
Bronchopulmonary dysplasia (BPD) is a common complication of preterm birth. Despite this, genetic drivers of BPD are poorly understood. The objective of this study is to better understand the impact of single nucleotide polymorphisms (SNPs) previously associated with BPD by examining associations with other phenotypes. We drew pediatric subjects from the biorepository at the Center for Applied Genomics to identify associations between these SNPs and 2,146 imputed phenotypes. Methylation data, external cohorts, and in silico validation methods were used to corroborate significant associations. We identified 60 SNPs that were previously associated with BPD. We found a significant association between rs3771150 and rs3771171 and mean eosinophil percentage in a European cohort of 6,999 patients and replicated this in external cohorts. Both SNPs were also associated with asthma, COPD and FEV1/FVC ratio. These SNPs displayed associations with methylation probes and were functionally linked to ST2 (IL1RL1) levels in blood and lung tissue. Our findings support a genetic justification for the epidemiological link between BPD and asthma. Given the well-established link between ST2 and type 2 inflammation in asthma, these findings provide a rationale for future studies exploring the role of type 2 inflammation in the pathogenesis of BPD.
Asunto(s)
Asma , Displasia Broncopulmonar , Eosinofilia , Fenotipo , Polimorfismo de Nucleótido Simple , Humanos , Displasia Broncopulmonar/genética , Displasia Broncopulmonar/patología , Masculino , Femenino , Eosinofilia/genética , Niño , Asma/genética , Proteína 1 Similar al Receptor de Interleucina-1/genética , Predisposición Genética a la Enfermedad , Recién Nacido , Estudio de Asociación del Genoma Completo , Preescolar , Metilación de ADN , LactanteRESUMEN
Immune activation status determines non-small cell lung cancer (NSCLC) prognosis, with reported positive/negative associations for T helper type 2 (TH2) responses, including allergen-specific IgE and eosinophils. Our study seeks to explore the potential impact of these comorbid immune responses on the survival rates of patients with NSCLC. Our retrospective study used data from the Data Warehouse of the German Center for Lung Research (DZL) and Lung Biobank at Thoraxklinik Heidelberg. We estimated the association of blood eosinophilia and neutrophilia on survival rates in an inflammatory cohort of 3143 patients with NSCLC. We also tested sensitization to food and inhalants and high-sensitivity C-reactive protein (hs-CRP) in a comorbidity cohort of 212 patients with NSCLC. Finally, we estimated the infiltration of immune-relevant cells including eosinophils, T-cells, and mast cells in a tissue inflammatory sub-cohort of 60 patients with NSCLC. Sensitization to at least one food or inhalant (sIgE) was higher in patients with adenocarcinoma (adeno-LC) than the non-adenocarcinoma (non-adeno-LC). Furthermore, hs-CRP was higher in non-adeno-LC compared with adeno-LC. Peripheral inflammation, particularly eosinophilia and neutrophilia, was associated with poor survival outcomes in NSCLC with a clear difference between histological subgroups. Finally, blood eosinophilia was paralleled by significant eosinophil infiltration into the peritumoral tissue in the lung. This study provides novel perspectives on the crucial role of peripheral inflammation, featuring eosinophilia and neutrophilia, with overall survival, underscoring distinctions between NSCLC subgroups (adeno-LC vs. non-adeno-LC). Peripheral eosinophilia enhances eosinophil infiltration into tumors. This sheds light on the complex interplay between inflammation, eosinophil infiltration, and NSCLC prognosis among various histological subtypes. Further studies are required to underscore the role of eosinophils in NSCLC among different histological subgroups and their role in shaping the tumor microenvironment.
Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas , Eosinofilia , Eosinófilos , Neoplasias Pulmonares , Humanos , Carcinoma de Pulmón de Células no Pequeñas/patología , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Carcinoma de Pulmón de Células no Pequeñas/inmunología , Femenino , Masculino , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/mortalidad , Neoplasias Pulmonares/inmunología , Eosinófilos/patología , Eosinófilos/inmunología , Eosinofilia/patología , Eosinofilia/inmunología , Eosinofilia/mortalidad , Anciano , Persona de Mediana Edad , Estudios Retrospectivos , Inflamación/patología , Inflamación/inmunología , Neutrófilos/inmunología , Neutrófilos/patología , PronósticoRESUMEN
Eosinophilia is a challenge to our everyday clinical practice. There are multiple causes to consider when diagnosing eosinophilia, and drug hypersensitivity must be taken into account. It is especially difficult to manage it in hospitalized patients with multiple complications and infections. Allergy tests are not always as helpful as we would like, so we rely on clinical observation and laboratory analysis to establish our diagnosis. We present a unique clinical case because the same patient presented two clinical episodes of eosinophilia after the administration of Carbapenems in the context of abdominal infection.
Asunto(s)
Antibacterianos , Carbapenémicos , Eosinofilia , Humanos , Eosinofilia/inducido químicamente , Eosinofilia/diagnóstico , Carbapenémicos/efectos adversos , Antibacterianos/efectos adversos , Masculino , Hipersensibilidad a las Drogas/diagnóstico , Hipersensibilidad a las Drogas/etiología , Persona de Mediana Edad , FemeninoRESUMEN
INTRODUÇÃO A endomiocardiofibrose (EMF) é uma cardiomiopatia restritiva, caracterizada por envolvimento fibrótico do endocárdio e miocárdio normalmente na região apical, levando a disfunção diastólica, porém, preservando função sistólica. É uma doença de etiologia desconhecida e ainda muito relacionada a países subdesenvolvidos com forte relação às síndromes hipereosinofilicas. Seu diagnóstico pode ser aventado através do ecodopplercardiograma e ressonância magnética cardíaca, podendo muitas vezes ser confundida com trombo em região apical ventricular. DESCRIÇÃO DO CASO Paciente de 38 anos, feminina, proveniente de São Paulo capital. Relata internação anterior há 4 meses em serviço externo por quadro de dor torácica com alteração de enzimas cardíacas, porém, sem evidência de coronariopatia isquêmica na Cinecoronariografia. Evidenciado em ecocardiograma transtorácico (ECOTT) uma hipertrofia excêntrica do ventrículo esquerdo (VE) com imagem hiperecogênica em região apical de 19mm podendo corresponder a trombo. Prosseguindo a investigação, realizada uma ressonância magnética cardíaca descrevendo trombo aderido à parede do ventrículo esquerdo, medindo 2,3 cm, além de hipocinesia dos segmentos apicais e realce miocárdico tardio subendocárdico não transmural nos segmentos apicais. A mesma comparece ao serviço com novo episódio de dispneia e dor precordial, agora com sinais de hipervolemia e hipereosinofilia (>1500). Em novo ECOTT realizado evidenciou-se aumento biatrial, disfunção sistólica do ventrículo direito, hipertensão pulmonar, refluxo de grau importante em valva mitral e tricúspide associado a uma obliteração do ápice em parede endocárdica até base do VE, poupando demais paredes, sugestivo de EMF. Com base nos exames iniciais, configurou-se o diagnóstico de EMF pela ressonância magnética e sua correlação com hipereosinofilia. Dessa forma, após o diagnóstico a paciente evolui com melhora clínica e seguirá tratamento em ambulatório do miocárdio. CONCLUSÕES Relatamos um caso de EMF associada a hipereosinofilia ainda em investigação etiológica. O caso supracitado traz uma paciente jovem proveniente de um país em desenvolvimento com diagnóstico de uma doença ainda pouco compreendida e de difícil diagnóstico, podendo muitas vezes passar-se como um trombo em região apical cardíaca, gerando subdiagnósticos e manejo incorreto.
Asunto(s)
Humanos , Femenino , Adulto , Fibrosis Endomiocárdica/diagnóstico , Eosinofilia , Dolor en el Pecho , Cardiomiopatía Restrictiva , Espectroscopía de Resonancia Magnética , DisneaRESUMEN
Eosinophilic gastroenteritis poses a significant diagnostic challenge, particularly in developing countries, where the awareness of this condition may be limited. Here, the case of a patient in her early 30s, who presented with recurrent episodes of abdominal pain and diarrhea, is reported. Initial standard laboratory investigations revealed normal complete blood counts and elevated total serum immunoglobulin E levels. Upper and lower endoscopic evaluations with systemic biopsies did not reveal any significant abnormalities. However, computed tomography revealed a thickened small intestine wall, halo signs, and mild ascites. Analysis of the ascitic fluid confirmed eosinophilia. These findings prompted a diagnosis of eosinophilic gastroenteritis. The patient responded well to a targeted elimination diet, corticosteroids, and antileukotriene medication. The present case emphasizes the importance of considering eosinophilic gastroenteritis in the differential diagnosis of patients who present with abdominal pain and eosinophilic ascites.
Asunto(s)
Ascitis , Enteritis , Eosinofilia , Gastritis , Humanos , Eosinofilia/diagnóstico , Eosinofilia/patología , Ascitis/diagnóstico , Ascitis/patología , Ascitis/etiología , Femenino , Enteritis/diagnóstico , Enteritis/patología , Vietnam , Gastritis/diagnóstico , Gastritis/patología , Gastritis/complicaciones , Adulto , Tomografía Computarizada por Rayos X , Dolor Abdominal/etiología , Dolor Abdominal/diagnóstico , Diagnóstico DiferencialRESUMEN
Eosinophilic gastroenteritis (EG) is an inflammatory bowel condition characterised by eosinophilic infiltration of the stomach and small bowel. Smoking and certain foods can trigger EG.A man in his 40s presented to the emergency department with acute abdominal pain. He had rebound tenderness and guarding on his initial abdominal examination. A subsequent CT scan showed jejunal wall thickening and ascitesHe had similar attacks of abdominal pain and was misdiagnosed with familial Mediterranean fever and Crohn's disease.Paracentesis revealed eosinophilic ascites. No mucosal abnormality was detected on gastroduodenoscopy and colonoscopy. A double-balloon enteroscopy revealed mucosal inflammation in the jejunum and a biopsy was taken. In this biopsy, eosinophilic jejunitis was detected. He was given corticosteroids and montelukast and his condition was resolved promptly. After discharge, he had attacks of EG until he quit smoking. After quitting smoking, he had an attack once in the last 2 years after consuming eggplant.
Asunto(s)
Abdomen Agudo , Ascitis , Enteritis , Eosinofilia , Gastritis , Humanos , Masculino , Eosinofilia/diagnóstico , Eosinofilia/complicaciones , Abdomen Agudo/etiología , Enteritis/diagnóstico , Enteritis/complicaciones , Enteritis/tratamiento farmacológico , Gastritis/diagnóstico , Gastritis/complicaciones , Adulto , Ascitis/etiología , Diagnóstico Diferencial , Tomografía Computarizada por Rayos XRESUMEN
Objective: To investigate the clinicopathological features and differential diagnosis of eosinophilic vacuolated tumor (EVT). Methods: Seven cases of EVT with characteristic morphology and unequivocal diagnosis from the Affiliated Hospital of Qingdao University (6 cases), Qingdao, China and the 971 Hospital of PLA Navy (1 case), Qingdao, China between January 2010 and December 2021 were subject to morphological and immunohistochemical analyses. Additionally, whole exome sequencing (WES) was performed in two cases. Twenty-two cases of renal oncocytoma (RO) and 17 cases of eosinophilic chromophobe renal cell carcinoma (eChRCC) diagnosed at the same time were used as controls. Results: Four males and three females with a mean age of 42 years (range: 29-61 years) were included in the study. The tumors were nodular and well-circumscribed, with sizes ranging from 1.5 to 4.5 cm. On cross-section, they appeared gray-red or gray-white, solid, and soft. Tumor cells were arranged in nests, solid sheets, and acinar or small vesicular structures. These cells exhibited eosinophilic cytoplasm with large, prominent clear vacuoles and round nuclei with prominent nucleoli. Perinuclear halos were focally present in four cases, while small tumor cells with sparse cytoplasm and hyperchromatic nuclei were seen in one case. No necrosis or mitosis was noted. Edematous stroma was detected in three cases. All tumors were positive for CD117 and Cathepsin K, but negative for vimentin and CK7. CK20 was positive in scattered individual cells, and Ki-67 positivity ranged from 1% to 4%. Point mutations in MTOR were identified in both patients who were subject to the molecular analysis. Statistical differences in the expression of Cathepsin K, CD10, S-100A1, and Cyclin D1 between EVT and RO (P<0.05) were significant, so were the differences in the expression of Cathepsin K, CD10, CK7 and claudin 7 between EVT and eChRCC (P<0.001). Seven patients were followed up for 4 to 96 months (mean, 50 months), with no recurrences or metastases. Conclusions: EVT is a rare renal tumor that shares morphological and immunophenotypic features with RO and eChRCC, and it is closely linked to the TSC/MTOR pathway. The presence of large prominent transparent vacuoles in eosinophilic cytoplasm along with conspicuous nucleoli is its key morphological characteristics. The use of combined immunohistochemical stains greatly aids in its diagnosis. Typically, the tumor exhibits indolent biological behaviors with a favorable prognosis.
Asunto(s)
Carcinoma de Células Renales , Neoplasias Renales , Humanos , Masculino , Femenino , Persona de Mediana Edad , Adulto , Neoplasias Renales/patología , Neoplasias Renales/metabolismo , Neoplasias Renales/genética , Carcinoma de Células Renales/patología , Carcinoma de Células Renales/metabolismo , Carcinoma de Células Renales/genética , Diagnóstico Diferencial , Vacuolas/patología , Eosinófilos/patología , Eosinofilia/patología , Eosinofilia/metabolismoRESUMEN
INTRODUCTION: Hirschsprung disease (HSCR) is a disorder caused by the failure of neural crest migration leading to an aganglionic colon and functional obstruction. Transabdominal Yancey-Soave pull-through is one of the definitive therapies for this condition. Prognostic factors, including sex, aganglionosis type, age at definitive surgery, nutritional status, eosinophilia and lymphocytosis, might influence the outcomes of the pull-through. We evaluated the functional outcomes of HSCR patients after Yancey- Soave surgery and associated them with the prognostic factors. MATERIALS AND METHODS: The study included Hirschsprung patients aged ≥3 and <18 years who underwent Yancey- Soave surgery at our hospital. The functional outcomes were evaluated using the Krickenbeck classification to determine voluntary bowel movement (VBM), constipation and soiling. RESULTS: Most (82.6%) patients showed VBM, 26.1% had constipation and 4.3% suffered from soiling. Among 23 patients who received Yancey-Soave surgery, 8 (34.8%) had eosinophilia and 5 (21.7%) had lymphocytosis. However, no significant differences were observed between eosinophilia and non-eosinophilia groups for VBM (p=1.0), constipation (p= 0.621) or soiling (p=0.738). Similarly, no significant differences were found between lymphocytosis and nonlymphocytosis groups for VBM (p=1.0), constipation (p=0.545) or soiling (p=0.973). Moreover, no other prognostic factors affected the functional outcomes after Yancey- Soave surgery (p>0.05). CONCLUSION: Our study shows that eosinophilia and lymphocytosis might not affect the functional outcome of patients with HSCR following Yancey-Soave surgery. In addition, sex, aganglionosis type, age at definitive surgery and nutritional status might not influence the functional outcome after definitive surgery. Further, a more extensive study is essential to clarify our findings.
Asunto(s)
Eosinofilia , Enfermedad de Hirschsprung , Linfocitosis , Humanos , Enfermedad de Hirschsprung/cirugía , Enfermedad de Hirschsprung/complicaciones , Enfermedad de Hirschsprung/fisiopatología , Masculino , Femenino , Preescolar , Linfocitosis/etiología , Niño , Adolescente , Resultado del Tratamiento , Estudios Retrospectivos , PronósticoAsunto(s)
Proteína Catiónica del Eosinófilo , Eosinofilia , Humanos , Masculino , Persona de Mediana Edad , Síndrome de Hipersensibilidad a Medicamentos/diagnóstico , Síndrome de Hipersensibilidad a Medicamentos/etiología , Síndrome de Hipersensibilidad a Medicamentos/inmunología , Síndrome de Hipersensibilidad a Medicamentos/sangre , Proteína Catiónica del Eosinófilo/sangre , Eosinofilia/inducido químicamente , Eosinofilia/diagnóstico , Exantema/inducido químicamente , Exantema/diagnósticoRESUMEN
Chromosomal rearrangements involving Janus kinase 2 (JAK2) are rare but recurrent findings in lymphoid or myeloid neoplasia. Detection of JAK2 fusion genes is important as patients with aberrantly activated JAK2 may benefit from treatment with tyrosine kinase inhibitors such as ruxolitinib. Here, we report a novel fusion gene between the transcriptional co-repressor-encoding gene transducin-like enhancer of split 3 (TLE3) and JAK2 in a patient initially diagnosed with chronic eosinophilic leukemia with additional mutations in PTPN11 and NRAS. The patient was successfully treated with the JAK2 inhibitor ruxolitinib for 8 months before additional somatic mutations were acquired and the disease progressed into an acute lymphoblastic T-cell leukemia/lymphoma. The present case shows similarities to previously reported cases with PCM1::JAK2 and BCR::JAK2 with regard to disease phenotype and response to ruxolitinib, and importantly, provides an example that also patients harboring other JAK2 fusion genes may benefit from treatment with JAK2 inhibitors.
Asunto(s)
Janus Quinasa 2 , Nitrilos , Proteínas de Fusión Oncogénica , Pirimidinas , Humanos , Janus Quinasa 2/genética , Janus Quinasa 2/antagonistas & inhibidores , Proteínas de Fusión Oncogénica/genética , Nitrilos/uso terapéutico , Pirimidinas/uso terapéutico , Masculino , Pirazoles/uso terapéutico , Eosinofilia/genética , Eosinofilia/tratamiento farmacológico , Eosinofilia/patología , Inhibidores de Proteínas Quinasas/uso terapéuticoRESUMEN
Eosinophils have the potential to exhibit both anti-tumor properties and tumor-promoting effects. However, the impact of eosinophil levels in the bloodstream on tumorigenesis risk remains inadequately explored. Furthermore, investigations regarding the association between drugs regulating eosinophils and cancer risk are currently absent. In this study, we conducted a Mendelian randomization (MR) analysis utilizing eosinophil count and eosinophil percentage as exposures. In both cohorts, a significant association was observed between eosinophil count and the risk of colorectal cancer and skin malignancies. However, upon conducting a sensitivity analysis, heterogeneity was detected specifically in relation to skin malignancies. Subsequent reverse Mendelian randomization analysis did not indicate any evidence of reverse causality. Furthermore, the multivariate Mendelian randomization analysis results suggested that eosinophils act as a mediating factor in reducing the risk of colorectal cancer and skin malignancies in individuals with asthma. And the use of drugs that modulate eosinophilia may increase the risk of colorectal cancer. It is evident that the statistical evidence supporting a negative correlation between eosinophils count and the susceptibility to colorectal cancer is particularly robust. And, it is plausible to suggest that pharmaceutical interventions aimed at modulating eosinophilia may potentially heighten the risk of colorectal cancer. Hence, it is imperative to exercise caution and remain mindful of the potential risk of colorectal cancer when employing these medications.
Asunto(s)
Neoplasias Colorrectales , Eosinofilia , Eosinófilos , Análisis de la Aleatorización Mendeliana , Humanos , Neoplasias Colorrectales/genética , Neoplasias Colorrectales/epidemiología , Eosinofilia/genética , Eosinofilia/epidemiología , Recuento de Leucocitos , Factores de RiesgoRESUMEN
BACKGROUND: As an opportunistic pathogenic fungus, Schizophyllum has been rarely reported to infect humans. By reporting a case of definite diagnosis of Schizophyllum infection, we aim to improve clinicians' understanding of this bacterium. METHODS: By reporting a case with cough and sputum as the main manifestations, after empirical antiinfective chest CT suggesting a more progressive inflammatory lesion and a mass-like lesion in the paratracheal area of the main airways, a diagnosis of Schizophyllum infection was finally made by bronchoscopy with the delivery of metagenomic next-generation sequencing (mNGS). RESULTS: The patient was finally diagnosed with rare Schizophyllum infection. After antifungal treatment, the symptoms improved, and the patient was discharged. CONCLUSIONS: Although Schizophyllum is a rare fungal infection, it should be taken seriously in patients with diabetes or who are immunocompromised. At the same time, mNGS plays a key role in the detection of rare and emerging pathogens, which is worthy of clinical interest.
Asunto(s)
Antifúngicos , Schizophyllum , Humanos , Schizophyllum/aislamiento & purificación , Schizophyllum/genética , Antifúngicos/uso terapéutico , Eosinofilia/diagnóstico , Eosinofilia/microbiología , Masculino , Broncoscopía , Secuenciación de Nucleótidos de Alto Rendimiento , Tomografía Computarizada por Rayos X , Enfermedades Pulmonares Fúngicas/diagnóstico , Enfermedades Pulmonares Fúngicas/microbiología , Enfermedades Pulmonares Fúngicas/tratamiento farmacológico , Persona de Mediana Edad , Micosis/diagnóstico , Micosis/microbiología , Micosis/tratamiento farmacológico , Micosis/complicacionesRESUMEN
Introduction: Chronic inflammation of the gastrointestinal tissues underlies gastrointestinal inflammatory disorders, leading to tissue damage and a constellation of painful and debilitating symptoms. These disorders include inflammatory bowel diseases (Crohn's disease and ulcerative colitis), and eosinophilic disorders (eosinophilic esophagitis and eosinophilic duodenitis). Gastrointestinal inflammatory disorders can often present with overlapping symptoms necessitating the use of invasive procedures to give an accurate diagnosis. Methods: This study used peripheral blood mononuclear cells from individuals with Crohn's disease, ulcerative colitis, eosinophilic esophagitis, and eosinophilic duodenitis to better understand the alterations to the transcriptome of individuals with these diseases and identify potential markers of active inflammation within the peripheral blood of patients that may be useful in diagnosis. Single-cell RNA-sequencing was performed on peripheral blood mononuclear cells isolated from the blood samples of pediatric patients diagnosed with gastrointestinal disorders, including Crohn's disease, ulcerative colitis, eosinophilic esophagitis, eosinophilic duodenitis, and controls with histologically healthy gastrointestinal tracts. Results: We identified 730 (FDR < 0.05) differentially expressed genes between individuals with gastrointestinal disorders and controls across eight immune cell types. Discussion: There were common patterns among GI disorders, such as the widespread upregulation of MTRNR2L8 across cell types, and many differentially expressed genes showed distinct patterns of dysregulation among the different gastrointestinal diseases compared to controls, including upregulation of XIST across cell types among individuals with ulcerative colitis and upregulation of Th2-associated genes in eosinophilic disorders. These findings indicate both overlapping and distinct alterations to the transcriptome of individuals with gastrointestinal disorders compared to controls, which provide insight as to which genes may be useful as markers for disease in the peripheral blood of patients.
Asunto(s)
Eosinofilia , Análisis de la Célula Individual , Humanos , Niño , Masculino , Femenino , Eosinofilia/genética , Eosinofilia/inmunología , Adolescente , Gastritis/genética , Gastritis/diagnóstico , Gastritis/inmunología , Transcriptoma , Esofagitis Eosinofílica/genética , Esofagitis Eosinofílica/diagnóstico , Esofagitis Eosinofílica/inmunología , Preescolar , Colitis Ulcerosa/genética , Colitis Ulcerosa/diagnóstico , Colitis Ulcerosa/inmunología , Enteritis/genética , Enteritis/diagnóstico , Enteritis/inmunología , Perfilación de la Expresión Génica , Enfermedad de Crohn/genética , Enfermedad de Crohn/diagnóstico , Enfermedad de Crohn/inmunología , Leucocitos Mononucleares/metabolismo , Leucocitos Mononucleares/inmunología , Genómica/métodos , BiomarcadoresRESUMEN
Eosinophilic otitis media, first reported in Japan, is a viscous, intractable otitis media often linked to bronchial asthma and chronic rhinosinusitis, characterized by highly viscous middle ear effusion. Its pathological mechanism remains unclear and the condition occasionally does not respond to steroids. It is now recognized as a rare type 2 inflammatory disease and should be treated specifically to enhance quality of life. This systematic review and meta-analysis evaluated the efficacies of biologic treatments. We searched PubMed, SCOPUS, Embase, Web of Science, and Cochrane databases up to September 2023. We retrieved ear examination findings, otitis media-related and symptom scores, air-bone gaps and hearing thresholds, serum eosinophil, and immunoglobulin E (IgE) levels before and after biologic treatments. Biologics treatment significantly improved subjective otitis media-related scores, compared with control group (standard mean difference (SMD) -1.62; 95% confidence interval (CI) [-2.24; -1.01], I2=54%). Additionally, the serum eosinophil counts and IgE levels significantly decreased (SMD -1.40; 95% CI [-1.99; -0.81], I 2=0%) after 6-12 months of biologic treatments, but the hearing thresholds did not significantly change. There were no significant differences between groups treated with dupilumab and groups treated with other biologics. Biologics treatment for eosinophilic otitis media significantly improved subjective otitis media-related scores and decreased serum eosinophil and IgE levels, but no significant changes in hearing threshold. More randomized cohort studies are needed to confirm the efficacies of biologics in patients with refractory eosinophilic otitis media.