RESUMEN
In patients with eosinophilic esophagitis (EoE), symptoms often do not correlate with peak eosinophil counts (PEC) determined on histopathological examination of biopsy specimens. This may be because eosinophils degranulate during active disease and lose their morphological identity as intact cells and, therefore, are not enumerated on microscopic examination. Eosinophil granule proteins that are released into tissues with degranulation, including major basic protein 1 (eMBP1), likely contribute to disease pathogenesis and, therefore, may correlate with symptoms better than PEC. We sought to determine whether symptoms in patients with EoE more closely relate to eosinophil granule protein deposition than to eosinophil enumeration, especially in patients with fewer than 15 eosinophils per high power field (HPF). Esophageal biopsy specimens from 34 patients diagnosed with EoE were obtained for histopathological examination and for evaluation of eMBP1 staining by indirect immunofluorescence. PEC by histopathology were compared to extracellular eMBP1 grades by immunostaining. PEC and eMBP1 grades also were analyzed for their relationship to symptoms and clinical course. Biopsy specimens from 19 of the 34 patients had fewer than 15 PEC on histopathological examination, and the other 15 patients had 15 or greater PEC. Positive eMBP1 immunostaining was found in all symptomatic patients. EoE symptoms were related to eMBP1 immunostaining grades (p = 0.0001), but not PEC (P = 0.14). Eosinophil granule protein deposition, specifically eMBP1, is increased in esophageal biopsy specimens from symptomatic patients with EoE and may be a marker of disease activity, including patients with EoE who have 'resolved' disease.
Asunto(s)
Proteína Mayor Básica del Eosinófilo/metabolismo , Esofagitis Eosinofílica/metabolismo , Esofagitis Eosinofílica/patología , Eosinófilos/patología , Proteoglicanos/metabolismo , Adulto , Anciano , Enfermedades Asintomáticas , Biomarcadores/metabolismo , Biopsia , Mucosa Esofágica/patología , Femenino , Humanos , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Evaluación de Síntomas , Adulto JovenRESUMEN
Chorioangioma is a common primary tumor of the placenta. Most tumors are small and are only detected by careful sectioning of the placenta. Large tumors can be diagnosed antenatally by ultrasonography and may result in maternal and fetal complications.
Asunto(s)
Hemangioma/complicaciones , Enfermedades Placentarias/complicaciones , Complicaciones del Embarazo , Trombocitopenia/complicaciones , Adulto , Cesárea , Femenino , Hemangioma/diagnóstico por imagen , Humanos , Enfermedades Placentarias/diagnóstico por imagen , Embarazo , Resultado del Embarazo , Radiografía , UltrasonografíaRESUMEN
Ovarian tumor in pregnancy is a distressing problem for the obstetrician. A physician must differentiate between a manifestation of a normal physiological condition and a serious pathological condition. Fortunately an ovarian tumor in pregnancy is rare. Once the condition is suspected, a physician should use all available tools to confirm the diagnosis. A patient should be treated accordingly, keeping in mind the age of the patient, the gestational age, and the biology of different types of the tumor.
