Bismuthene - Tetrahedral DNA nanobioconjugate for virus detection.

In this work, we present an electrochemical sensor for fast, low-cost, and easy detection of the SARS-CoV-2 spike protein in infected patients. The sensor is based on a selected combination of nanomaterials with a specific purpose. A bioconjugate formed by Few-layer bismuthene nanosheets (FLB) and tetrahedral DNA nanostructures (TDNs) is immobilized on Carbon Screen-Printed Electrodes (CSPE). The TDNs contain on the top vertex an aptamer that specifically binds to the SARS-CoV-2 spike protein, and a thiol group at the three basal vertices to anchor to the FLB. The TDNs are also marked with a redox indicator, Azure A (AA), which allows the direct detection of SARS-CoV-2 spike protein through changes in the current intensity of its electrolysis before and after the biorecognition reaction. The developed sensor can detect SARS-CoV-2 spike protein with a detection limit of 1.74 fg mL-1 directly in nasopharyngeal swab human samples. Therefore, this study offers a new strategy for rapid virus detection since it is versatile enough for different viruses and pathogens.

Rapid and simple viral protein detection by functionalized 2D MoS2/graphene electrochemiluminescence aptasensor.

In this work we present the development of an electrochemiluminescence aptasensor based on electrografting molybdenum disulphide nanosheets functionalized with diazonium salt (MoS2-N2+) upon screen-printed electrodes of graphene (SPEs GPH) for viral proteins detection. In brief, this aptasensor consists of SPEs GPH electrografted with MoS2-N2+ and modified with a thiolated aptamer, which can specifically recognize the target protein analyte. In this case, we have used SARS-CoV-2 spike protein as model protein. Electrochemiluminescence detection was performed by using the [Ru(bpy)3]2+/TPRA (tripropylamine) system, which allows the specific detection of the SARS-CoV-2 spike protein easily and rapidly with a detection limit of 9.74 fg/mL and a linear range from 32.5 fg/mL to 50.0 pg/mL. Moreover, the applicability of the aptasensor has been confirmed by the detection of the protein directly in human saliva samples. Comparing our device with a traditional saliva antigen test, our aptasensor can detect the spike protein even when the saliva antigen test gives a negative result.

Free PCR virus detection via few-layer bismuthene and tetrahedral DNA nanostructured assemblies.

In this work we describe a highly sensitive method based on a biocatalyzed electrochemiluminescence approach. The system combines, for the first time, the use of few-layer bismuthene (FLB) as a platform for the oriented immobilization of tetrahedral DNA nanostructures (TDNs) specifically designed and synthetized to detect a specific SARS-CoV-2 gene sequence. In one of its vertices, these TDNs contain a DNA capture probe of the open reading frame 1 ab (ORF1ab) of the virus, available for the biorecognition of the target DNA/RNA. At the other three vertices, there are thiol groups that enable the stable anchoring/binding to the FLB surface. This novel geometry/approach enables not only the binding of the TDNs to surfaces, but also the orientation of the capture probe in a direction normal to the bismuthine surface so that it is readily accessible for binding/recognition of the specific SARS-CoV-2 sequence. The analytical signal is based on the anodic electrochemiluminescence (ECL) intensity of luminol which, in turn, arises as a result of the reaction with H2O2, generated by the enzymatic reaction of glucose oxidation, catalyzed by the biocatalytic label avidin-glucose oxidase conjugate (Av-GOx), which acts as co-reactant in the electrochemiluminescent reaction. The method exhibits a limit of detection (LOD) of 4.31 aM and a wide linear range from 14.4 aM to 1.00 µM, and its applicability was confirmed by detecting SARS-CoV-2 in nasopharyngeal samples from COVID-19 patients without the need of any amplification process.

A "signal off-on" fluorescence bioassay based on 2D-MoS2-tetrahedral DNA bioconjugate for rapid virus detection.

In this work we present the preparation of a 2D molybdenum disulphide nanosheets (2D-MoS2) and tetrahedral DNA nanostructures (TDNs) bioconjugate, and its application to the development of a bioassay for rapid and easy virus detection. The bioconjugate has been prepared by using TDNs carrying the capture probe labelled with 6-carboxyfluoresceine (6-FAM). As case of study to assess the utility of the assay developed, we have chosen the SARS-CoV-2 virus. Hence, as probe we have used a DNA sequence complementary to a region of the SARS-CoV-2 ORF1ab gene (TDN-ORF-FAM). This 6-FAM labelled capture probe is located on the top vertex of the tetrahedral DNA nanostructure, the three left vertices of TDNs have a thiol group. These TDNs are bounded to 2D-MoS2 surface through the three thiol groups, allowing the capture probe to be oriented to favour the biorecognition reaction with the analyte. This biorecognition resulting platform has finally been challenged to the detection of the SARS-CoV-2 ORF1ab gene sequence as the target model by measuring fluorescence before and after the hybridization event with a detection limit of 19.7fM. Furthermore, due to high sensitivity of the proposed methodology, it has been applied to directly detect the virus in nasopharyngeal samples of infected patients without the need of any amplification step. The developed bioassay has a wide range of applicability since it can be applied to the detection of any pathogen by changing the probe corresponding to the target sequence. Thus, a novel, hands-on strategy for rapid pathogen detection has proposed and has a high potential application value in the early diagnosis of infections causes by virus or bacteria.

Multiplex Portable Biosensor for Bacteria Detection.

An advanced, cost-effective, and portable DNA biosensor capable of detecting multiple bacteria simultaneously has been developed. The biosensor comprises a fast and inexpensive potentiostat that controls the applied potential to a screen-printed electrochemical array platform functionalized with MoS2 flakes and bacterial DNA probes. The current response obtained by à la carte thionine functionalized carbon nanodots (Ty-CDs) is monitored as an electrochemical indicator of the hybridization event. The design of the potentiostat prioritizes achieving an optimal signal-to-noise ratio and incorporates a user-friendly interface compatible with various devices, including computers, mobile phones, and tablets. The device is compact, lightweight, and manufactured at a low cost. The key components of the potentiostat include a data acquisition board capable of analyzing multiple samples simultaneously and a controller board. The results of this study confirm the ability of the multiplex portable biosensor to successfully detect specific bacterial DNA sequences, demonstrating its reliability and superior performance compared with a traditional, more complex, and laboratory-oriented potentiostat.

MoS2-Carbon Nanodots as a New Electrochemiluminescence Platform for Breast Cancer Biomarker Detection.

In this work, we present the combination of two different types of nanomaterials, 2D molybdenum disulfide nanosheets (MoS2-NS) and zero-dimensional carbon nanodots (CDs), for the development of a new electrochemiluminescence (ECL) platform for the early detection and quantification of the biomarker human epidermal growth factor receptor 2 (HER2), whose overexpression is associated with breast cancer. MoS2-NS are used as an immobilization platform for the thiolated aptamer, which can recognize the HER2 epitope peptide with high affinity, and CDs act as coreactants of the anodic oxidation of the luminophore [Ru(bpy)3]2+. The HER2 biomarker is detected by changes in the ECL signal of the [Ru(bpy)3]2+/CD system, with a low detection limit of 1.84 fg/mL and a wide linear range. The proposed method has been successfully applied to detect the HER2 biomarker in human serum samples.

Optoception: Perception of Optogenetic Brain Perturbations.

How do animals experience brain manipulations? Optogenetics has allowed us to manipulate selectively and interrogate neural circuits underlying brain function in health and disease. However, little is known about whether mice can detect and learn from arbitrary optogenetic perturbations from a wide range of brain regions to guide behavior. To address this issue, mice were trained to report optogenetic brain perturbations to obtain rewards and avoid punishments. Here, we found that mice can perceive optogenetic manipulations regardless of the perturbed brain area, rewarding effects, or the stimulation of glutamatergic, GABAergic, and dopaminergic cell types. We named this phenomenon optoception, a perceptible signal internally generated from perturbing the brain, as occurs with interoception. Using optoception, mice can learn to execute two different sets of instructions based on the laser frequency. Importantly, optoception can occur either activating or silencing a single cell type. Moreover, stimulation of two brain regions in a single mouse uncovered that the optoception induced by one brain region does not necessarily transfer to a second not previously stimulated area, suggesting a different sensation is experienced from each site. After learning, they can indistinctly use randomly interleaved perturbations from both brain regions to guide behavior. Collectively taken, our findings revealed that mice's brains could "monitor" perturbations of their self-activity, albeit indirectly, perhaps via interoception or as a discriminative stimulus, opening a new way to introduce information to the brain and control brain-computer interfaces.

Paving the way to point of care (POC) devices for SARS-CoV-2 detection.

In this work we present a powerful, affordable, and portable biosensor to develop Point of care (POC) SARS-CoV-2 virus detection. It is constructed from a fast, low cost, portable and electronically automatized potentiostat that controls the potential applied to a disposable screen-printed electrochemical platform and the current response. The potentiostat was designed to get the best signal-to-noise ratio, a very simple user interface offering the possibility to be used by any device (computer, mobile phone or tablet), to have a small and portable size, and a cheap manufacturing cost. Furthermore, the device includes as main components, a data acquisition board, a controller board and a hybridization chamber with a final size of 10 × 8 × 4 cm. The device has been tested by detecting specific SARS-CoV-2 virus sequences, reaching a detection limit of 22.1 fM. Results agree well with those obtained using a conventional potentiostat, which validate the device and pave the way to the development of POC biosensors. In this sense, the device has finally applied to directly detect the presence of the virus in nasopharyngeal samples of COVID-19 patients and results confirm its utility for the rapid detection infected samples avoiding any amplification process.

Amplification-free detection of SARS-CoV-2 using gold nanotriangles functionalized with oligonucleotides.

Gold nanotriangles (AuNTs) functionalized with dithiolated oligonucleotides have been employed to develop an amplification-free electrochemical biosensor for SARS-CoV-2 in patient samples. Gold nanotriangles, prepared through a seed-mediated growth method and exhaustively characterized by different techniques, serve as an improved electrochemical platform and for DNA probe immobilization. Azure A is used as an electrochemical indicator of the hybridization event. The biosensor detects either single stranded DNA or RNA sequences of SARS-CoV-2 of different lengths, with a low detection limit of 22.2 fM. In addition, it allows to detect point mutations in SARS-CoV-2 genome with the aim to detect more infective SARS-CoV-2 variants such as Alpha, Beta, Gamma, Delta, and Omicron. Results obtained with the biosensor in nasopharyngeal swab samples from COVID-19 patients show the possibility to clearly discriminate between non-infected and infected patient samples as well as patient samples with different viral load. Furthermore, the results correlate well with those obtained by the gold standard technique RT-qPCR, with the advantage of avoiding the amplification process and the need of sophisticated equipment.

Electrochemiluminescent nanostructured DNA biosensor for SARS-CoV-2 detection.

This work focuses on the development of an electrochemiluminescent nanostructured DNA biosensor for SARS-CoV-2 detection. Gold nanomaterials (AuNMs), specifically, a mixture of gold nanotriangles (AuNTs) and gold nanoparticles (AuNPs), are used to modified disposable electrodes that serve as an improved nanostructured electrochemiluminescent platform for DNA detection. Carbon nanodots (CDs), prepared by green chemistry, are used as coreactants agents in the [Ru(bpy)3]2+ anodic electrochemiluminescence (ECL) and the hybridization is detected by changes in the ECL signal of [Ru(bpy)3]2+/CDs in combination with AuNMs nanostructures. The biosensor is shown to detect a DNA sequence corresponding to SARS-CoV-2 with a detection limit of 514 aM.

Photoinduced Charge Transfer and Trapping on Single Gold Metal Nanoparticles on TiO2.

We present a study of the effect of gold nanoparticles (Au NPs) on TiO2 on charge generation and trapping during illumination with photons of energy larger than the substrate band gap. We used a novel characterization technique, photoassisted Kelvin probe force microscopy, to study the process at the single Au NP level. We found that the photoinduced electron transfer from TiO2 to the Au NP increases logarithmically with light intensity due to the combined contribution of electron-hole pair generation in the space charge region in the TiO2-air interface and in the metal-semiconductor junction. Our measurements on single particles provide direct evidence for electron trapping that hinders electron-hole recombination, a key factor in the enhancement of photo(electro)catalytic activity.

LINC00460 Is a Dual Biomarker That Acts as a Predictor for Increased Prognosis in Basal-Like Breast Cancer and Potentially Regulates Immunogenic and Differentiation-Related Genes.

Breast cancer (BRCA) is a serious public health problem, as it is the most frequent malignant tumor in women worldwide. BRCA is a molecularly heterogeneous disease, particularly at gene expression (mRNAs) level. Recent evidence shows that coding RNAs represent only 34% of the total transcriptome in a human cell. The rest of the 66% of RNAs are non-coding, so we might be missing relevant biological, clinical or regulatory information. In this report, we identified two novel tumor types from TCGA with LINC00460 deregulation. We used survival analysis to demonstrate that LINC00460 expression is a marker for poor overall (OS), relapse-free (RFS) and distant metastasis-free survival (DMFS) in basal-like BRCA patients. LINC00460 expression is a potential marker for aggressive phenotypes in distinct tumors, including HPV-negative HNSC, stage IV KIRC, locally advanced lung cancer and basal-like BRCA. We show that the LINC00460 prognostic expression effect is tissue-specific, since its upregulation can predict poor OS in some tumors, but also predicts an improved clinical course in BRCA patients. We found that the LINC00460 expression is significantly enriched in the Basal-like 2 (BL2) TNBC subtype and potentially regulates the WNT differentiation pathway. LINC00460 can also modulate a plethora of immunogenic related genes in BRCA, such as SFRP5, FOSL1, IFNK, CSF2, DUSP7 and IL1A and interacts with miR-103-a-1, in-silico, which, in turn, can no longer target WNT7A. Finally, LINC00460:WNT7A ratio constitutes a composite marker for decreased OS and DMFS in Basal-like BRCA, and can predict anthracycline therapy response in ER-BRCA patients. This evidence confirms that LINC00460 is a master regulator in BRCA molecular circuits and influences clinical outcome.

FAM83H-AS1 is a potential modulator of cancer driver genes across different tumors and a prognostic marker for ER/PR + BRCA patients.

Breast cancer (BRCA) is a serious public health problem, as it is the most frequent malignant tumor in women worldwide. BRCA is a molecularly heterogenic disease, particularly at gene expression (mRNAs) level. Recent evidence shows that coding RNAs represent only 34% of the total transcriptome in a human cell. The rest of the 66% of RNAs are non-coding, so we might be missing relevant biological, clinical or regulatory information. In this report, we identified nine novel tumor types from TCGA with FAM83H-AS1 deregulation. We used survival analysis to demonstrate that FAM83H-AS1 expression is a marker for poor survival in IHC-detected ER and PR positive BRCA patients and found a significant correlation between FAM83H-AS1 overexpression and tamoxifen resistance. Estrogen and Progesterone receptor expression levels interact with FAM83H-AS1 to potentiate its effect in OS prediction. FAM83H-AS1 silencing impairs two important breast cancer related pathways: cell migration and cell death. Among the most relevant potential FAM83H-AS1 gene targets, we found p63 and claudin 1 (CLDN1) to be deregulated after FAM83H-AS1 knockdown. Using correlation analysis, we show that FAM83H-AS1 can regulate a plethora of cancer-related genes across multiple tumor types, including BRCA. This evidence suggests that FAM83H-AS1 is a master regulator in different cancer types, and BRCA in particular.

Lateral Hypothalamic GABAergic Neurons Encode and Potentiate Sucrose's Palatability.

Sucrose is attractive to most species in the animal kingdom, not only because it induces a sweet taste sensation but also for its positive palatability (i.e., oromotor responses elicited by increasing sucrose concentrations). Although palatability is such an important sensory attribute, it is currently unknown which cell types encode and modulate sucrose's palatability. Studies in mice have shown that activation of GABAergic LHAVgat+ neurons evokes voracious eating; however, it is not known whether these neurons would be driving consumption by increasing palatability. Using optrode recordings, we measured sucrose's palatability while VGAT-ChR2 transgenic mice performed a brief access sucrose test. We found that a subpopulation of LHAVgat+ neurons encodes palatability by increasing (or decreasing) their activity as a function of the increment in licking responses evoked by sucrose concentrations. Optogenetic gain of function experiments, where mice were able to choose among available water, 3% and 18% sucrose solutions, uncovered that opto-stimulation of LHAVgat+ neurons consistently promoted higher intake of the most palatable stimulus (18% sucrose). In contrast, if they self-stimulated near the less palatable stimulus, some VGAT-ChR2 mice preferred water over 18% sucrose. Unexpectedly, activation of LHAVgat+ neurons increased quinine intake but only during water deprivation, since in sated animals, they failed to promote quinine intake or tolerate an aversive stimulus. Conversely, these neurons promoted overconsumption of sucrose when it was the nearest stimulus. Also, experiments with solid foods further confirmed that these neurons increased food interaction time with the most palatable food available. We conclude that LHAVgat+ neurons increase the drive to consume, but it is potentiated by the palatability and proximity of the tastant.

Pediatric precordial pain, Hospital Español de México's experience.

Introduction: Pediatric precordial pain is a frequent cause for pediatric consultation in the emergency room (ER) services - about 0.3-0.6% of all consultations - and it can cause a lot of stress to families who tend to associate it with a more severe pathology, this pathology mostly presents itself between the ages of 11 and 14 years. Objective: The objective of this study was to determine the precordial pain's etiology and to analyze the semiology and approach toward the ailment by ER service in a private hospital. Methods: A retrospective, observational, descriptive, transversal study that took place from January 2014 to May 2017. Results: A total of 48 precordial pain patients were identified, four of them had a positive family background. Most of the pain was not referred as associated to symptoms, and the type of pain was non-specific in 62% of the cases. The most frequent duration of the pain was < 8 h in 54.1% and without any irradiation. There was only one case associated with the presence of cardiac precordial pain pathology regarding pulmonary hypertension; this signified an incidence of 2%, similar to what has been previously published in other articles.

Introducción: El dolor precordial en pediatría es una causa frecuente de consulta en los servicios de urgencias, representando entre el 0.3-0.6% de todas las consultas en estos. servicios. Su edad de presentación más frecuente oscila entre los 11 y 14 años de edad. Objetivo: Determinar la etiología del dolor precordial así como analizar la semiología y el abordaje del mismo en el servicio de urgencias en un hospital privado de la ciudad de México. Metodología: Estudio retrospectivo, observacional, descriptivo, transversal, que se desarrolló de Enero del 2014 a Mayo del 2017. Resultados: Se estudiaron 48 pacientes, 4 tenian antecedentes familiares de importancia positivos, en su mayoría, los pacientes no refirieron síntomas asociados. En 62% de los pacientes refirieron un dolor precordial inespecífico en cuanto al tipo de dolor, en 54% la duración del dolor fue de 8 h sin irradiación. Solo se reporta un caso asociado a etiología cardíaca siendo un caso de hipertensión arterial pulmonar; con esto concluímos un incidencia del 2%.

Gastroenteritis aguda por norovirus en pacientes con atención hospitalaria: estudio transversal / Acute gastroenteritis due to norovirus in patients with hospital care: a cross-sectional study

Resumen Introducción: Debido a la disponibilidad de técnicas moleculares en la atención clínica, las gastroenteritis agudas (GEA) por norovirus han retomado importancia como un agente causante de hospitalización. El objetivo de este estudio fue describir las características clínicas y evolutivas de pacientes menores de 16 años hospitalizados por GEA por norovirus. Métodos: Estudio retrospectivo. Se recabó información clínica de los pacientes atendidos en hospitalización del 1 de noviembre del 2016 al 28 de febrero del 2018 por GEA con detección de norovirus (genotipo I y II) en heces por medio de reacción en cadena de la polimerasa con transcriptasa inversa. Resultados: Estudiamos 103 pacientes; 96 (93.2%; intervalo de confianza del 95% [IC 95%]: 86.6-96.7%) con deteccion de genotipo II y 7 (6.8%; IC 95%: 5.3-8.7%) de genotipo I; 76 (73.8%) ≤5 anos. El 48.5% fueron atendidos durante el invierno. La evolucion fue a la autolimitacion en menos de 7 días en todos con manejo hidroelectrolitico. No hubo diferencias en la gravedad y sintomas segun el grupo viral: en ambos predominaron los vómitos (82%). Solo un paciente cursó con perforación intestinal por coinfección con Shigella sp.; tres pacientes (3.1%) manifestaron crisis convulsivas (dos febriles y una epiléptica). Conclusiones: La GEA por norovirus, a pesar de causar una enfermedad meritoria de hospitalización, tiene un pronóstico favorable con autolimitación rápida. Su detección por pruebas rápidas en heces podría evitar la prescripción injustificada de antibióticos.

Abstract Background: Because of the availability of molecular techniques in clinical care, acute gastroenteritis (AGE) due to norovirus has returned to importance as a causative agent of hospitalization. The aim of this study was to describe the clinical features and evolution of patients less than 16 years hospitalized for AGE associated with norovirus. Methods: Retrospective study. Clinical information of the patients attended from November 1, 2016 to February 28, 2018 by AGE with detection of norovirus (genotype I and II) in faeces by means of polymerase chain reaction with reverse transcriptase was collected. Results: We studied 103 patients; 96 (93.2%; 95% confidence interval [95% CI]: 86.6-96.7%) with genotype II detection and seven (6.8%; 95% CI: 5.3-8.7%) genotype I; 76 (73.8%) ≤5 years. 48.5% attended during the winter. The evolution was to self-limitation in less than 7 days in all with hydro electrolytic management. There were no differences in the severity and symptoms according to the viral group; in both cases the vomiting predominated (82%). Only one patient had intestinal perforation due to co-infection with Shigella sp.; three patients (3.1%) manifested seizures (two febrile and one epileptic convulsions). Conclusions: Despite causing a meritorious disease of hospitalization, GEA by norovirus has a favorable prognosis with rapid self-limitation. Its timely detection by rapid tests in feces could avoid the unjustified prescription of antibiotics.

Acute gastroenteritis due to norovirus in patients with hospital care: a cross-sectional study.

Background: Because of the availability of molecular techniques in clinical care, acute gastroenteritis (AGE) due to norovirus has returned to importance as a causative agent of hospitalization. The aim of this study was to describe the clinical features and evolution of patients less than 16 years hospitalized for AGE associated with norovirus. Methods: Retrospective study. Clinical information of the patients attended from November 1, 2016 to February 28, 2018 by AGE with detection of norovirus (genotype I and II) in faeces by means of polymerase chain reaction with reverse transcriptase was collected. Results: We studied 103 patients; 96 (93.2%; 95% confidence interval [95% CI]: 86.6-96.7%) with genotype II detection and seven (6.8%; 95% CI: 5.3-8.7%) genotype I; 76 (73.8%) ≤5 years. 48.5% attended during the winter. The evolution was to self-limitation in less than 7 days in all with hydro electrolytic management. There were no differences in the severity and symptoms according to the viral group; in both cases the vomiting predominated (82%). Only one patient had intestinal perforation due to co-infection with Shigella sp.; three patients (3.1%) manifested seizures (two febrile and one epileptic convulsions). Conclusions: Despite causing a meritorious disease of hospitalization, GEA by norovirus has a favorable prognosis with rapid self-limitation. Its timely detection by rapid tests in feces could avoid the unjustified prescription of antibiotics.

Introducción: Debido a la disponibilidad de técnicas moleculares en la atención clínica, las gastroenteritis agudas (GEA) por norovirus han retomado importancia como un agente causante de hospitalización. El objetivo de este estudio fue describir las características clínicas y evolutivas de pacientes menores de 16 años hospitalizados por GEA por norovirus. Métodos: Estudio retrospectivo. Se recabó información clínica de los pacientes atendidos en hospitalización del 1 de noviembre del 2016 al 28 de febrero del 2018 por GEA con detección de norovirus (genotipo I y II) en heces por medio de reacción en cadena de la polimerasa con transcriptasa inversa. Resultados: Estudiamos 103 pacientes; 96 (93.2%; intervalo de confianza del 95% [IC 95%]: 86.6-96.7%) con detección de genotipo II y 7 (6.8%; IC 95%: 5.3-8.7%) de genotipo I; 76 (73.8%) ≤5 años. El 48.5% fueron atendidos durante el invierno. La evolución fue a la autolimitación en menos de 7 días en todos con manejo hidroelectrolítico. No hubo diferencias en la gravedad y síntomas según el grupo viral: en ambos predominaron los vómitos (82%). Solo un paciente cursó con perforación intestinal por coinfección con Shigella sp.; tres pacientes (3.1%) manifestaron crisis convulsivas (dos febriles y una epiléptica). Conclusiones: La GEA por norovirus, a pesar de causar una enfermedad meritoria de hospitalización, tiene un pronóstico favorable con autolimitación rápida. Su detección por pruebas rápidas en heces podría evitar la prescripción injustificada de antibióticos.

Hypereosinophilic syndrome in an infant / Síndrome hipereosinofílico en un lactante

Abstract Background The hypereosinophilic syndrome (HES) is defined by an eosinophilic count > 1500 cell/mm3 and organ damage or dysfunction that can be easily mistaken for atopic dermatitis or pulmonary pathologies. Timely diagnosis and treatment can improve the prognosis and avoid heart and renal complications or lung fibrosis. Case report The case of an infant is reported with a 24-h evolution of cough and fever, personal history of atopic dermatitis, and a generalized dermatosis 2 months earlier. In the initial approach, respiratory disease was considered. However, blood count reported hypereosinophilia, which led to further studies and the diagnosis of the HES. Conclusions Although a rare pathology, it is important to consider the HES in children with common symptoms, and unusual evolution or poor treatment response and persistent hypereosinophilia.

Resumen Introducción El síndrome hipereosinofílico se define por la cuenta de eosinófilos > 1,500 células/mm3 con daño orgánico o disfunción, sin ninguna causa subyacente. Puede ser fácilmente confundido con una dermatitis atópica o con patologías pulmonares. El diagnóstico temprano y el tratamiento adecuado pueden mejorar el pronóstico y evitar complicaciones cardíacas y renales o el desarrollo de fibrosis pulmonar. Caso clínico Se reporta el caso de un lactante con tos y fiebre de 24 horas de evolución y una historia personal de dermatitis atópica, además de dermatosis generalizada dos meses antes. Inicialmente, se consideró como una enfermedad respiratoria; sin embargo, la cuenta de células sanguíneas reportó hipereosinofilia, lo cual condujo a estudios confirmatorios y al diagnóstico de síndrome hipereosinofílico. Conclusiones A pesar de ser una enfermedad rara, es de suma importancia considerar el síndrome hipereosinofílico en el diagnóstico diferencial en niños con una evolución atípica o con pobre respuesta al tratamiento, además de hipereosinofilia persistente.