Exploration of useful clinical laboratory values as diagnostic criteria for eosinophilic gastroenteritis.

BACKGROUND: Eosinophilic gastroenteritis (EGE) is a rare eosinophilic infiltrative disorder. In Japan, EGE is diagnosed using clinical symptoms as well as microscopic, haematologic and histopathological findings. In this study, we examined the usefulness of laboratory data in the diagnosis of EGE. METHODS: Patients who were diagnosed with EGE at Fujita Health University Bantane Hospital between April 2015 and December 2020 were enrolled in this study and their data was retrospectively analysed. We evaluated their medical history, laboratory data including leukocyte count, eosinophil count, immunoglobulin (Ig) E, thymus and activation-regulated chemokine (TARC), C-reactive protein (CRP), etc. and histopathological data were collected from the electronic medical records. RESULTS: One hundred twelve of 168 patients who were treated for EGE could be analysed. The peripheral eosinophil count was correlated with the duodenal or ascending colon eosinophil count; moreover, the blood lymphocyte count and the TARC were correlated with the transverse colon eosinophil count. Multivariate regression analysis showed correlations only in the oesophagus, stomach and duodenum. Specifically, correlations were noted between blood eosinophils and gastric eosinophils, blood eosinophils and duodenal eosinophils, blood lymphocytes and gastric eosinophils, blood IgE and oesophageal, gastric and duodenal eosinophils and CRP and oesophageal eosinophils. CONCLUSION: The extent of blood eosinophil count, lymphocyte count, IgE and CRP elevation together with clinical features and pathology can be incorporated into a diagnostic scoring criteria system to improve the accuracy of diagnosing this uncommon condition in the future.

[The Safety of Super-Selective Intra-Arterial Infusion Chemotherapy for Induction with Docetaxel, Cisplatin, and 5-Fluorouracil for Oral Cancer].

Adverse events and complications were retrospectively evaluated in 13 oral cancer patients receiving 3-drug, super-selective, intra-arterial infusion induction chemotherapy with docetaxel, cisplatin, and 5-fluorouracil (GroupA ), and another 13 patients receiving systemic chemotherapy (GroupB ). As a systemic adverse event, neutropenia was significantly milder in GroupA than in GroupB (p=0.043). However, among local adverse events, the incidence rates of oral mucous membrane disorders were 69.2% (9 patients) in GroupA and 23.1% (3 patients)in GroupB, and therefore significantly higher in Group A(p=0.021). No significant difference was observed between the two groups considering the time of onset of oral mucous membrane disorders. Among complications, there were no cerebral infarctions, but facial palsy occurred in 1 patient. Thus, in a comparison between adverse events associated with super-selective intra-arterial infusion induction chemotherapy for oral cancer and systemic chemotherapy, the former showed milder neutropenia and a trend toward milder systemic adverse events. However, the incidence rate of oral mucositis as a local adverse event was significantly higher. For super-selective intra-arterial infusion chemotherapy, it appears to be important to prevent oral mucositis and to control the risks of complications such as facial palsy and cerebral infarction.

[Complex regional pain syndrome in a patient with acute drug poisoning: a case report].

We report a case with transition to complex regional pain syndrome (CRPS) caused by nerve injury associated with crush syndrome. The diagnosis was delayed because of coma due to acute drug poisoning. A 44-year-old man had attempted suicide by taking massive amounts of psychotropic drugs 2 days earlier and was transported to our hospital by ambulance. His arms had been compressed due to the prolonged (2 days) consciousness disturbance, and he experienced non-traumatic crush syndrome and rhabdomyolysis. Acute renal failure was prevented with massive infusion and hemofiltration. However, he experienced muscle and nerve injury at the compressed area, which presumably led to CRPS. In cases of suspected crush syndrome associated with acute drug poisoning, it is also important to recognize the possibility of developing CRPS.