RESUMEN
Eosinophil sombrero vesicles are large tubular carriers resident in the cytoplasm of human eosinophils, identifiable by transmission electron microscopy, and important for immune mediator transport. Increased formation of sombrero vesicles occurs in activated eosinophils in vitro and in vivo. In tissue sites of eosinophilic cytolytic inflammation, extracellular eosinophil sombrero vesicles are noted, but their frequency and significance in eosinophil-associated diseases remain unclear. Here, we performed comprehensive quantitative transmission electron microscopy analyses and electron tomography to investigate the numbers, density, integrity, and 3-dimensional structure of eosinophil sombrero vesicles in different biopsy tissues from 5 prototypic eosinophil-associated diseases (eosinophilic chronic rhinosinusitis/nasal sinuses, ulcerative colitis/intestines, hypereosinophilic syndrome/skin, dermatitis/skin, and schistosomiasis/rectum). The morphology of extracellular eosinophil sombrero vesicles was also compared with that of cytoplasmic eosinophil sombrero vesicles, isolated by subcellular fractionation from peripheral blood eosinophils. We demonstrated that (i) eosinophil cytolysis, releasing intact sombrero vesicles and membrane-bound granules, is a consistent event in all eosinophil-associated diseases; (ii) eosinophil sombrero vesicles persist intact even after complete disintegration of all cell organelles, except granules (late cytolysis); (iii) the eosinophil sombrero vesicle population, composed of elongated, curved, and typical sombreros, and the eosinophil sombrero vesicle 3-dimensional architecture, diameter, and density remain unchanged in the extracellular matrix; (iv) free eosinophil sombrero vesicles closely associate with extracellular granules; and (v) free eosinophil sombrero vesicles also associate with externalized chromatin during eosinophil ETosis. Remarkably, eosinophil sombrero vesicles appeared on the surface of other cells, such as plasma cells. Thus, eosinophil cytolysis/ETosis can secrete intact sombrero vesicles, alongside granules, in inflamed tissues of eosinophil-associated diseases, potentially serving as propagators of eosinophil immune responses after cell death.
Asunto(s)
Degranulación de la Célula , Eosinófilos , Vesículas Extracelulares , Humanos , Eosinófilos/inmunología , Eosinófilos/patología , Vesículas Extracelulares/inmunología , Vesículas Extracelulares/metabolismo , Masculino , Eosinofilia/inmunología , Eosinofilia/patología , Síndrome Hipereosinofílico/patología , Síndrome Hipereosinofílico/inmunologíaRESUMEN
BACKGROUND: Traumatic Ulcerative Granuloma with Stromal Eosinophilia, commonly known as Eosinophilic Ulcer, is a reactive solitary and self-limiting benign lesion. It manifests as a punched-out ulcer with a distinct surrounding indurated border, often raising concerns about malignancy. METHODS: A 44-year-old male presented with a painless, indurated tongue ulcer evolving over three months. Despite being asymptomatic, the patient underwent an incisional biopsy due to suspicions of oral squamous cell carcinoma. RESULTS: Histological analysis revealed a disrupted epithelial lining, dense necrotic connective tissue, and a fibrino-purulent pseudomembrane. Proximal to the ulcer, a collar-like projection of reactive epithelial tissue hyperplasia was noted, accompanied by mononuclear cells and a predominantly histiocytic infiltrate in the submucosal layer surrounding skeletal muscle fibers. The final diagnosis was Traumatic Ulcerative Granuloma with Stromal Eosinophilia. Remarkably, the lesion spontaneously healed within 2 weeks post-biopsy, with no recurrence over 6 months. CONCLUSION: This case emphasizes considering this benign condition in the differential diagnosis of oral ulcers, highlighting the importance of accurate histopathological evaluation to rule out cancer.
Asunto(s)
Carcinoma de Células Escamosas , Eosinofilia , Neoplasias de Cabeza y Cuello , Neoplasias de la Boca , Úlceras Bucales , Masculino , Humanos , Adulto , Úlcera/patología , Carcinoma de Células Escamosas/patología , Neoplasias de la Boca/patología , Granuloma/patología , Eosinofilia/patología , Lengua/patología , Úlceras Bucales/diagnóstico , Tejido Conectivo/patología , Neoplasias de Cabeza y Cuello/patologíaRESUMEN
OBJECTIVE AND DESIGN: The hallmark of type 2 inflammation is eosinophilia and/or high IgE serum levels, mostly in atopic dermatitis. Nevertheless, many dermatoses may present similar findings. Our aim is to explore the biological and clinical spectrum of cutaneous manifestations involving tissue and/or systemic eosinophilia, and distinct serum levels of IgE, where atopic dermatitis or other primary allergic eczema, not always is the definitive diagnosis. MATERIALS/METHODS: A total of 37 scientific papers were enrolled in this narrative review. RESULTS: A diagnostic approach for patients with elevated serum IgE level and a list of conditions not related to atopic dermatitis that runs through inborn errors of immunity, inflammatory disorders, lung disorders, malignancy, infections/infestations are displayed. Regarding to peripheral eosinophilia, differential diagnosis is also explored and clinical patterns of skin diseases associated with tissue eosinophilia are listed, to facilitate our diagnosis. CONCLUSIONS: We should maintain a high level of suspicion about other differential diagnosis involving eosinophilia and IgE dysregulation, especially in patients very young (when innate errors of the immunity may present) and in middle to elderly patients classified as having atopic dermatitis, due to the possibility of cutaneous hematological malignancies, paraneoplasia or autoimmune blistering diseases.
Asunto(s)
Dermatitis Atópica , Eosinofilia , Humanos , Anciano , Inmunoglobulina E , Eosinofilia/diagnóstico , Eosinofilia/complicaciones , Eosinofilia/patología , Eosinófilos , Piel/patologíaRESUMEN
Cardiac disease is of importance in captive chimpanzee (Pan troglodytes) health. Here we report an eosinophilic and necrotizing myocarditis in a 17-y-old chimpanzee with no previous history of cardiac disease that progressed to death within 48 h. Toxic and infectious causes were ruled out. The chimpanzee had eosinophilia at different occasions in previous years. The animal had a severe, diffuse, and acute monophasic necrotizing myocarditis, with a moderate lymphoplasmacytic infiltrate that was rich in eosinophils. Ante- and postmortem investigations are compatible with an unusual eosinophilic myocarditis with clinical evolution and morphology comparable with human eosinophilic myocarditis secondary to hypereosinophilic syndrome.
Asunto(s)
Enfermedades del Simio Antropoideo/patología , Eosinofilia/veterinaria , Miocarditis/veterinaria , Miocardio/patología , Pan troglodytes , Animales , Eosinofilia/patología , Resultado Fatal , Masculino , Miocarditis/patología , Necrosis/patología , Necrosis/veterinariaRESUMEN
The different pathologies of the prostate, involve the presence of a new microenvironment where inflammatory cells are actively recruited. This research explores the presence of mast cells and eosinophils associated with age and the evaluation of prostate cancer progress (Gleason Index). Forty two biopsies of anonymized patients, with confirmed prostate cancer, were used for histological analysis for eosinophils and mast cells and subsequent determination of Gleason index according to age. The results of the histological analyzes show the presence of eosinophils and mast cells in prostate biopsies with confirmed cancer. In the multiple correlation studies, a high correlation was observed between the presence of lymphocytes and the age of the patient diagnosed with prostate cancer, same correlation was observed between the patient's age and higher Gleason Index (Pearson and Spearman p< 0.05). It is concluded that in prostate biopsies from Chilean patients with confirmed cancer, eosinophilia and tissue mastocytosis were observed. Correlation analyzes show a direct correlation between older patients, higher Gleason index and presence of mast cell. Regarding eosinophilia, only a correlation between age and Gleason index was observed Further studies are suggested to determine that the presence of eosinophils and mast cells can be used as early bioindicators of prostate cancer.
Las diferentes patologías de próstata, involucran la presencia de un nuevo microambiente donde las células inflamatorias son activamente reclutadas. La presente investigación explora la presencia de mastocitos y eosinófilos asociadas a la edad y la evaluación del progreso del cáncer de próstata según índice de Gleason. Cuarenta y dos biopsias de pacientes anonimizados, con cáncer prostático confirmados, fueron utilizadas para su análisis histológico para eosinófilos y mastocitos y posterior determinación del índice de Gleason según edad. Los resultados de los análisis histológicos, muestran la presencia de eosinófilos y mastocitos en biopsias de próstata con cáncer confirmado. En los estudios de correlación múltiple, se observó una alta correlación entre la presencia de linfocitos, mastocitos y la edad del paciente diagnosticado con cáncer prostático, igual correlación se observó entre la edad del paciente y mayor índice de Gleason (Pearson y Spearman p<0,05). Se concluyó que en las biopsias de próstata de pacientes chilenos con cáncer confirmado, se observó eosinofilia y mastocitosis tisular. Los análisis de correlación muestran una correlación directa entre pacientes de mayor edad, índice de Gleason más alto y la presencia de mastocitos. Con respecto a la eosinofilia, solo se observó una correlación entre la edad y el índice de Gleason. Se sugieren estudios adicionales para determinar que la presencia de eosinófilos y mastocitos puede usarse como bioindicadores tempranos del cáncer de próstata.
Asunto(s)
Humanos , Masculino , Neoplasias de la Próstata/patología , Próstata/patología , Neoplasias de la Próstata/diagnóstico , Biopsia , Mastocitosis/patología , Biomarcadores de Tumor/análisis , Chile , Factores de Edad , Eosinofilia/patología , Detección Precoz del Cáncer , Clasificación del TumorRESUMEN
BACKGROUND: The role of Helicobacter pylori infection on eosinophilic infiltration in duodenal mucosa is poorly studied. An increase in the number of eosinophils in duodenum has been associated with functional dyspepsia. OBJECTIVE: To evaluate the influence of H. pylori infection on duodenal eosinophil count and the role of eosinophilic infiltrate of duodenum in functional dyspepsia. METHODS: Positive and negative H. pylori individuals were included. Both functional dyspeptic patients according to Rome III criteria (cases) and individuals without gastrointestinal symptoms (controls) were enrolled. They were submitted to upper endoscopy and H. pylori infection was verified by gastric histopathology and urease test. Eosinophils in the duodenal mucosa were counted in five high-power fields, randomly selected on slides of endoscopic biopsies. RESULTS: Thirty-nine H. pylori positive (mean age 40.5 and 69.2% women) and 24 negative patients (mean age 37.3 and 75% women) were included. The influence of the infection was observed in the duodenal eosinophil count, which was higher in infected individuals: median 13.2 vs 8.1 in non-infected individuals (P=0.005). When we analyzed patients according to symptoms, cases - mean age 39.6; 71.4% women - and controls - mean age 38.7; 71.4% women - had similar duodenal eosinophil count: median 11.9 and 12.6 respectively (P=0.19). CONCLUSIONS: We did not demonstrate association of duodenal eosinophil count with functional dyspepsia but found association with H. pylori infection.
Asunto(s)
Duodeno/patología , Dispepsia/microbiología , Eosinofilia/patología , Mucosa Gástrica/patología , Infecciones por Helicobacter/patología , Helicobacter pylori , Adulto , Biopsia , Estudios de Casos y Controles , Duodeno/microbiología , Dispepsia/patología , Femenino , Mucosa Gástrica/microbiología , Gastroscopía , Humanos , Masculino , Persona de Mediana EdadRESUMEN
INTRODUCTION: Eosinophilic angiocentric fibrosis (EAF) is a rare lesion that predominantly affects the upper respiratory tract. Its etiology is unknown and it has been recently associated with the IgG4- related disease (IgG4-RD) spectrum. To the author's knowledge, this is the sixth case report of the relationship between EAF and IgG4-RD. CASE REPORT: We report the case of a 37-year-old woman with nasal deformity and facial pain. The lesion was surgically excised. Histological examination revealed features of EAF with an IgG4/IgG plasma cell ratio â·73% and 31 IgG4 stained cells per high power field. No clinical or radiological recurrence was detected during follow-up. Serum IgG4 quantification one year after surgery was within normal limits. DISCUSSION: The relationship between both entities may have therapeutic impact because IgG4-RD of the head and neck has a high remission rate with corticosteroids and immunosuppressive therapy. Additional reports of this infrequent disease are necessary to elucidate appropriate treatment and prognosis.
Asunto(s)
Eosinofilia/patología , Fibrosis/patología , Enfermedad Relacionada con Inmunoglobulina G4/patología , Enfermedades Nasales/patología , Adulto , Femenino , HumanosRESUMEN
ABSTRACT BACKGROUND: The role of Helicobacter pylori infection on eosinophilic infiltration in duodenal mucosa is poorly studied. An increase in the number of eosinophils in duodenum has been associated with functional dyspepsia. OBJECTIVE: To evaluate the influence of H. pylori infection on duodenal eosinophil count and the role of eosinophilic infiltrate of duodenum in functional dyspepsia. METHODS: Positive and negative H. pylori individuals were included. Both functional dyspeptic patients according to Rome III criteria (cases) and individuals without gastrointestinal symptoms (controls) were enrolled. They were submitted to upper endoscopy and H. pylori infection was verified by gastric histopathology and urease test. Eosinophils in the duodenal mucosa were counted in five high-power fields, randomly selected on slides of endoscopic biopsies. RESULTS: Thirty-nine H. pylori positive (mean age 40.5 and 69.2% women) and 24 negative patients (mean age 37.3 and 75% women) were included. The influence of the infection was observed in the duodenal eosinophil count, which was higher in infected individuals: median 13.2 vs 8.1 in non-infected individuals (P=0.005). When we analyzed patients according to symptoms, cases - mean age 39.6; 71.4% women - and controls - mean age 38.7; 71.4% women - had similar duodenal eosinophil count: median 11.9 and 12.6 respectively (P=0.19). CONCLUSIONS: We did not demonstrate association of duodenal eosinophil count with functional dyspepsia but found association with H. pylori infection.
RESUMO CONTEXTO: O papel de infecção por Helicobacter pylori no infiltrado eosinofílico duodenal ainda é pouco compreendido. Um aumento no número de eosinófilos duodenais tem sido associado a dispepsia funcional. OBJETIVO: Avaliar a influência do H. pylori na contagem de eosinófilos duodenais e o papel do infiltrado eosinofílico duodenal na dispepsia funcional. MÉTODOS: Indivíduos H. pylori positivo e negativo foram incluídos. Ambos os grupos, compreendendo dispépticos funcionais pelos critérios de Roma III (casos) e indivíduos sem sintomas gastrointestinais (controles), foram submetidos à endoscopia digestiva alta para pesquisa de H. pylori, efetuada por histopatologia e teste de urease. Eosinófilos na mucosa duodenal foram contabilizados em cinco campos de maior aumento, selecionados randomicamente nas lâminas de biópsia endoscópicas. RESULTADOS: Trinta e nove indivíduos H. pylori positivo (média de idade 40,5 e 69,2% mulheres) e 24 H. pylori negativos (média de idade 37,3 e 75% mulheres) foram incluídos. A influência da infecção por H. pylori foi observada na contagem de eosinófilos, que foi maior nos positivos: mediana 13,2 vs 8,1 (P=0,005). Quando analisados pacientes de acordo com sintomas, os casos (média de idade 39,6 e 71,4% mulheres) e controles (média de idade 38,7 e 71,4% mulheres), apresentaram semelhante contagem de eosinófilos duodenais: mediana 11,9 e 12,6, respectivamente (P=0,19). CONCLUSÃO: Não demonstramos associação da contagem de eosinófilos duodenais com dispepsia duodenal, mas encontramos associação com infecção por H. pylori.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Helicobacter pylori , Infecciones por Helicobacter/patología , Duodeno/patología , Dispepsia/microbiología , Eosinofilia/patología , Mucosa Gástrica/patología , Biopsia , Estudios de Casos y Controles , Gastroscopía , Duodeno/microbiología , Dispepsia/patología , Mucosa Gástrica/microbiología , Persona de Mediana EdadRESUMEN
Good's syndrome is a primary immunodeficiency phenocopy characterized for thymoma and immunodeficiency. The most frequent clinical presentation is recurrent or opportunistic infections, hematological alterations, and chronic diarrhea. We treated a 66-year-old man who consulted for 5 days of headache and diplopia with right sixth cranial nerve palsy at examination. Patient reported chronic diarrhea and prolonged febrile syndrome accompanied by weight loss of 23 kg in the last year. Exhaustive evaluation revealed Herpes simplex virus (HSV) type 2 meningitis, eosinophilic colitis, and type A thymoma. Severe antibody deficiency (hypogammaglobulinemia) associated with thymoma confirmed the diagnosis of Good's syndrome.
Asunto(s)
Agammaglobulinemia/patología , Colitis/patología , Enfermedades de los Nervios Craneales/patología , Herpes Simple/patología , Herpesvirus Humano 2/patogenicidad , Meningitis Viral/patología , Neoplasias Glandulares y Epiteliales/patología , Neoplasias del Timo/patología , Agammaglobulinemia/diagnóstico , Agammaglobulinemia/inmunología , Agammaglobulinemia/virología , Anciano , Colitis/diagnóstico , Colitis/inmunología , Colitis/virología , Enfermedades de los Nervios Craneales/diagnóstico , Enfermedades de los Nervios Craneales/inmunología , Enfermedades de los Nervios Craneales/virología , Diplopía/diagnóstico , Diplopía/inmunología , Diplopía/patología , Diplopía/virología , Eosinofilia/diagnóstico , Eosinofilia/inmunología , Eosinofilia/patología , Eosinofilia/virología , Cefalea/diagnóstico , Cefalea/inmunología , Cefalea/patología , Cefalea/virología , Herpes Simple/diagnóstico , Herpes Simple/inmunología , Herpes Simple/virología , Herpesvirus Humano 2/crecimiento & desarrollo , Herpesvirus Humano 2/inmunología , Humanos , Recuento de Linfocitos , Masculino , Meningitis Viral/diagnóstico , Meningitis Viral/inmunología , Meningitis Viral/virología , Neoplasias Glandulares y Epiteliales/diagnóstico , Neoplasias Glandulares y Epiteliales/inmunología , Neoplasias Glandulares y Epiteliales/virología , Neoplasias del Timo/diagnóstico , Neoplasias del Timo/inmunología , Neoplasias del Timo/virologíaRESUMEN
Eosinophil-associated diseases constitute a group of pathologies where eosinophils play an important role. Among them, eosinophilic gastroenteritis is a rare entity. Few demographic data exist in the literature, with an estimated prevalence of 28-30/100,000. The symptoms presented by patients mainly depend on the affected segment of the gastrointestinal tract and the layer infiltrated by eosinophils. We report a 22-year-old male patient with a one-month history of diarrhea, with mucus and occasionally hematic striae. Initial laboratory tests showed leukocytosis with eosinophilia, and imaging studies showed extensive involvement of the gastrointestinal tract characterized by diffuse concentric parietal thickening and submucosal edema associated with ascites. Upper endoscopy and biopsy confirmed the presence of foci of infiltration by eosinophils. The patient was treated with corticosteroids and a lactose and wheat free diet, with a favorable evolution, without relapse after stopping corticosteroid treatment.
Las enfermedades asociadas a eosinófilos constituyen un grupo de patologías en que el aumento de los eosinófilos presenta un rol fundamental, encontrándose entre ellas la gastroenteritis eosinofílica, entidad poco frecuente. En la literatura existen pocos datos demográficos, con una prevalencia estimada entre 28-30 /100.000 habitantes. Los síntomas dependen principalmente del segmento afectado del tracto gastrointestinal y de la capa de la pared infiltrada por eosinófilos. Se presenta el caso clínico de un paciente masculino de 22 años con cuadro de diarrea de un mes de evolución, asociado a mucosidad y ocasionalmente estrías hemáticas. El estudio de laboratorio inicial mostró leucocitosis con eosinofilia, realizándose estudios de imágenes que demuestran extenso compromiso del tubo digestivo caracterizado por engrosamiento parietal difuso concéntrico y edema submucoso del estómago como también de asas de intestino delgado, asociado a ascitis. La endoscopia digestiva alta y biopsia confirmaron la presencia de focos de infiltración por eosinófilos. El paciente fue tratado con corticoides y dieta con restricción de lactosa y trigo, con evolución favorable, sin recaída tras la suspensión del tratamiento corticoidal
Asunto(s)
Humanos , Masculino , Adulto Joven , Eosinofilia/diagnóstico por imagen , Gastroenteritis/diagnóstico por imagen , Biopsia , Tomografía Computarizada por Rayos X/métodos , Endoscopía Gastrointestinal , Eosinofilia/patología , Gastroenteritis/patologíaRESUMEN
Eosinophilic spongiosis is a histological feature shared by some distinct inflammatory disorders, and is characterized by the presence of intraepidermal eosinophils associated with spongiosis. Most often, isolated eosinophilic spongiosis indicates the early stages of a subjacent autoimmune bullous dermatosis, such as the pemphigus group and bullous pemphigoid. Herein, the main causes of eosinophilic spongiosis are discussed, as well as the supplementary investigation needed to elucidate its etiology.
Asunto(s)
Eosinofilia/diagnóstico , Eosinofilia/patología , Enfermedades Cutáneas Vesiculoampollosas/diagnóstico , Enfermedades Cutáneas Vesiculoampollosas/patología , Diagnóstico Diferencial , Epidermis/patología , Técnica del Anticuerpo Fluorescente Directa , HumanosRESUMEN
Abstract Eosinophilic spongiosis is a histological feature shared by some distinct inflammatory disorders, and is characterized by the presence of intraepidermal eosinophils associated with spongiosis. Most often, isolated eosinophilic spongiosis indicates the early stages of a subjacent autoimmune bullous dermatosis, such as the pemphigus group and bullous pemphigoid. Herein, the main causes of eosinophilic spongiosis are discussed, as well as the supplementary investigation needed to elucidate its etiology.
Asunto(s)
Humanos , Enfermedades Cutáneas Vesiculoampollosas/diagnóstico , Enfermedades Cutáneas Vesiculoampollosas/patología , Eosinofilia/diagnóstico , Eosinofilia/patología , Técnica del Anticuerpo Fluorescente Directa , Diagnóstico Diferencial , Epidermis/patologíaRESUMEN
Eosinophilic dermatosis of hematological malignancy is a paraneoplastic skin eruption associated with chronic lymphocytic leukemia and other B-cell malignancies. It clinically resembles an insect bite reaction and it can precede the symptoms of the hematological malignancy or be related to a more aggressive course. Different treatments have been proposed, but partial response and recurrence are frequent. Herein, we describe a case of eosinophilic dermatosis associated with mantle cell lymphoma with remission after lenalidomide therapy.
Asunto(s)
Eosinofilia/tratamiento farmacológico , Exantema/tratamiento farmacológico , Lenalidomida/uso terapéutico , Linfoma de Células del Manto/complicaciones , Síndromes Paraneoplásicos/tratamiento farmacológico , Prurito/tratamiento farmacológico , Eosinofilia/etiología , Eosinofilia/patología , Exantema/etiología , Exantema/patología , Humanos , Masculino , Persona de Mediana Edad , Síndromes Paraneoplásicos/etiología , Síndromes Paraneoplásicos/patología , Prurito/etiología , Prurito/patología , Piel/patología , Resultado del TratamientoAsunto(s)
Eosinofilia/patología , Paniculitis/patología , Toxocara canis/aislamiento & purificación , Toxocariasis/microbiología , Animales , Nalgas , Preescolar , Eosinofilia/complicaciones , Femenino , Humanos , Paniculitis/complicaciones , Piel/patología , Toxocariasis/complicaciones , Toxocariasis/diagnósticoRESUMEN
INTRODUCTION: Functional dyspepsia (FD) is a complex symptom. Currently there are multiple therapeutic options that are used for the management of these patients; however, FD therapies are based on symptomatic control and do not address the pathophysiological pathways involved in its development. The duodenum has been proposed as a key site to understand the complex pathophysiology involved in FD. OBJECTIVE: The aim of the study is to determine duodenal eosinophilia in patients with FD and establish the clinical-pathological correlation with the cardinal symptoms of dyspepsia. MATERIAL AND METHODS: Case-control study. Patients older than 18 years with dyspepsia according to the Rome IV criteria, and upper gastrointestinal endoscopy normal (FD group).Patients with iron deficiency anemia and chronic diarrhea (control group). Biopsies were taken in the stomach, duodenal bulb and second portion of duodenum. A sample size of 140 patients (70 patients in the FD group and 70 patients in the control group) was calculated. The collected information was described and analyzed by conventional statistical techniques. RESULTS: 243 patients were recruited. 84 patients were included in the FD group and 84 patients in the control group. 135 patients were women (80.3%). The mean age was 53.6 years (SD 14.9). Duodenal eosinophilia was found with significant difference in patients with early satiety (p=0.01). There was no difference in patients with postprandial fullness (p=0.63), epigastric pain or burning (p=0.26), gastroesophageal reflux symptoms (p=0.13), allergy and food intolerance (p=0.42) and smoking (p=0.28). There was no relationship between duodenal mastocytosis and early satiety (p=0.98), postprandial fullness (p=0.78), and epigastric pain or burning (p=0.82). CONCLUSIONS: Duodenal eosinophilia was similar in FD and controls. In subgroup analysis, duodenal eosinophilia occurs in patients with early satiety.
Asunto(s)
Enfermedades Duodenales/epidemiología , Dispepsia/epidemiología , Eosinofilia/epidemiología , Dolor Abdominal/epidemiología , Adulto , Anemia Ferropénica/patología , Estudios de Casos y Controles , Enfermedad Crónica , Comorbilidad , Diarrea/patología , Enfermedades Duodenales/patología , Dispepsia/patología , Eosinofilia/patología , Femenino , Intolerancia Alimentaria/epidemiología , Reflujo Gastroesofágico/epidemiología , Humanos , Masculino , Mastocitosis/epidemiología , Saciedad , Fumar/epidemiología , Evaluación de SíntomasRESUMEN
Eosinophilic fasciitis, or Shulman's disease, is a rare disease of unknown etiology. It is characterized by peripheral eosinophilia, hypergammaglobulinemia, and high erythrocyte sedimentation rate. The diagnosis is confirmed by a deep biopsy of the skin. The first line of treatment is corticotherapy. We present a rare case of eosinophilic fasciitis in a 27-year-old woman with an atypical presentation with symmetrical peripheral edema and a Groove sign. The patient responded well to treatment with corticosteroids at high doses and, in this context, was associated with hydroxychloroquine and azathioprine. After two and a half years, peripheral eosinophilia had increased, and more of her skin had hardened. At that time, the therapy was modified to include corticoids, methotrexate, and penicillamine. It is of great importance to publicize these cases that allow us to gather experience and better treat our patients.
Asunto(s)
Eosinofilia/patología , Fascitis/patología , Adulto , Biopsia , Edema/patología , Eosinofilia/diagnóstico por imagen , Eosinofilia/tratamiento farmacológico , Fascitis/diagnóstico por imagen , Fascitis/tratamiento farmacológico , Femenino , Humanos , Imagen por Resonancia Magnética , Enfermedades Raras , Piel/patología , Resultado del TratamientoAsunto(s)
Humanos , Animales , Femenino , Preescolar , Niño , Paniculitis/patología , Toxocariasis/microbiología , Toxocara canis/aislamiento & purificación , Eosinofilia/patología , Piel/patología , Nalgas , Paniculitis/complicaciones , Toxocariasis/complicaciones , Toxocariasis/diagnóstico , Eosinofilia/complicacionesRESUMEN
SUMMARY Eosinophilic fasciitis, or Shulman's disease, is a rare disease of unknown etiology. It is characterized by peripheral eosinophilia, hypergammaglobulinemia, and high erythrocyte sedimentation rate. The diagnosis is confirmed by a deep biopsy of the skin. The first line of treatment is corticotherapy. We present a rare case of eosinophilic fasciitis in a 27-year-old woman with an atypical presentation with symmetrical peripheral edema and a Groove sign. The patient responded well to treatment with corticosteroids at high doses and, in this context, was associated with hydroxychloroquine and azathioprine. After two and a half years, peripheral eosinophilia had increased, and more of her skin had hardened. At that time, the therapy was modified to include corticoids, methotrexate, and penicillamine. It is of great importance to publicize these cases that allow us to gather experience and better treat our patients.
RESUMO A fasciite eosinofílica ou doença de Shulman é uma doença rara de etiologia desconhecida. É caracterizada por eosinofilia periférica, hipergamaglobulinemia e velocidade de sedimentação eritrocitária elevada. O diagnóstico é confirmado por biópsia profunda da pele. O tratamento de primeira linha é a corticoterapia. Apresentamos um caso raro de fasciite eosinofílica numa mulher de 27 anos com uma apresentação atípica com edema periférico simétrico e sinal de Groove. A paciente respondeu bem ao tratamento com corticoides, mas em doses elevadas, e, nesse contexto, associou-se hidroxicloroquina e azatioprina. Ao fim de dois anos e meio verificou-se aumento de eosinofilia e novamente pele mais endurecida. Nessa altura alterou-se a terapêutica para corticoides, metrotexato e penicilamina. É de grande importância a divulgação desses casos que nos permitem reunir experiência e assim melhor tratar os nossos doentes.