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1.
J Med Life ; 14(1): 121-124, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33767797

RESUMO

This case report describes a rare case of progressive muscle weakness in a patient treated for eosinophilic fasciitis (EF) for many years before being diagnosed with a second autoimmune disease: dermatomyositis. Our case is a report of a 65-year-old male diagnosed with eosinophilic fasciitis 7 years before being evaluated in our service at Mayo Clinic in Jacksonville, Florida, due to progressive muscle weakness despite the chronic treatment with methotrexate. Contrast-enhanced magnetic resonance imaging of the lower extremity showed enhancement throughout the thigh musculature, which led us to pursue biopsies of the fascia and muscle in order to confirm the diagnosis of EF associated with myopathy. This case illustrates the need to consider the possibility of myopathy in patients diagnosed with EF whenever muscle weakness is more prominent than expected.


Assuntos
Eosinofilia/patologia , Fasciite/patologia , Idoso , Biópsia , Articulação do Cotovelo/patologia , Eosinofilia/diagnóstico por imagem , Eosinofilia/tratamento farmacológico , Fáscia/patologia , Fasciite/diagnóstico por imagem , Fasciite/tratamento farmacológico , Humanos , Imagem por Ressonância Magnética , Masculino , Metotrexato/uso terapêutico , Músculos/patologia , Atrofia Muscular/patologia , Pele/patologia
2.
Medicine (Baltimore) ; 100(13): e25359, 2021 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-33787639

RESUMO

RATIONALE: Eosinophilic fasciitis (EF) is an uncommon connective tissue disorder characterized by limb and trunk erythema, with symmetrical thickening of the skin. Its pathogenesis is poorly understood. Treatment consists mainly of glucocorticoids. Yet, no randomized trials have evaluated therapies for this rare disease and the optimal treatment modality remains unclear. Although most patients show partial or complete response to glucocorticoids, many relapse upon drug tapering, while others either do not respond at all or fail to sustain prolonged remission. Second-line therapy for this rare disorder includes mainly methotrexate (MTX), azathioprine, cyclosporine and hydroxychloroquine. Recently, several attempts using rituximab and intravenous immunoglobulins (IVIG) have shown good clinical results. PATIENT CONCERNS: The three patients had good clinical response to glucocorticoid treatment, followed by disease flare when the drug dose was tapered. Adding methotrexate in all patients and azathioprine to patient 3 did not lead to remission. DIAGNOSES: EF was diagnosed in all patients based on clinical presentation accompanied by fascia biopsy that demonstrated eosinophilic fasciitis. INTERVENTIONS: The patients were successfully treated with rituximab or IVIG, achieving sustained remission. OUTCOMES: The three cases had good clinical response to glucocorticoid treatment, followed by disease flare when the drug dose was tapered. The patients were then successfully treated with rituximab or IVIG, achieving sustained remission. LESSONS: This review of three cases of EF supports the results of previous reports, suggesting addition of rituximab and IVIG is an effective treatment for patients with refractory disease.


Assuntos
Produtos Biológicos/uso terapêutico , Eosinofilia/tratamento farmacológico , Fasciite/tratamento farmacológico , Glucocorticoides/farmacologia , Azatioprina/farmacologia , Azatioprina/uso terapêutico , Produtos Biológicos/farmacologia , Biópsia , Relação Dose-Resposta a Droga , Resistência a Medicamentos , Quimioterapia Combinada/métodos , Eosinofilia/imunologia , Eosinofilia/patologia , Fáscia/imunologia , Fáscia/patologia , Fasciite/imunologia , Fasciite/patologia , Feminino , Glucocorticoides/uso terapêutico , Humanos , Imunoglobulinas Intravenosas/farmacologia , Imunoglobulinas Intravenosas/uso terapêutico , Masculino , Metotrexato/farmacologia , Metotrexato/uso terapêutico , Pessoa de Meia-Idade , Prednisona/farmacologia , Prednisona/uso terapêutico , Rituximab/farmacologia , Rituximab/uso terapêutico , Exacerbação dos Sintomas , Resultado do Tratamento
3.
BMJ Case Rep ; 14(2)2021 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-33541980

RESUMO

Eosinophilic gastroenteritis is a rare inflammatory disorder of the gastrointestinal tract. Although commonly associated with allergic diseases, it is also rarely associated with autoimmune disorders. This case report describes a 17-year-old Filipino male with eosinophilic gastroenteritis, manifesting as abdominal pain, vomiting and diarrhoea. He had no allergic diseases, but he was previously diagnosed with chronic bullous disease. His symptoms improved with the initiation of corticosteroids. To date, this is the first case report of a patient with eosinophilic gastroenteritis and chronic bullous disease.


Assuntos
Enterite/diagnóstico , Eosinofilia/diagnóstico , Gastrite/diagnóstico , Gastroenterite/diagnóstico , Dor Abdominal/etiologia , Adolescente , Anti-Infecciosos/uso terapêutico , Apendicite/diagnóstico , Apendicite/tratamento farmacológico , Apendicite/cirurgia , Diarreia/etiologia , Enterite/tratamento farmacológico , Enterite/patologia , Eosinofilia/tratamento farmacológico , Eosinofilia/patologia , Gastrite/tratamento farmacológico , Gastrite/patologia , Gastroenterite/tratamento farmacológico , Humanos , Masculino , Metronidazol/uso terapêutico , Omento/patologia , Filipinas , Prednisona/uso terapêutico , Vômito/etiologia
4.
Methods Mol Biol ; 2241: 275-291, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33486743

RESUMO

Eosinophils are an important subtype of leukocytes derived from bone marrow multipotent hematopoietic stem cells and represent about 1% of leukocytes in circulating blood. In homeostatic conditions, eosinophils reside in the intestine to maintain the balance of immune responses by communicating with gut microbes without causing inflammation. However, under the stressed or diseased condition, eosinophils degranulate, releasing their granule-derived cytotoxic proteins that are involved in inflammatory responses. Various eosinophil-associated inflammatory diseases are eosinophilic esophagitis (EoE), eosinophilic gastroenteritis (EG), and eosinophilic colitis (EC), together called EGID, asthma, hypereosinophilic syndrome, and eosinophilic pneumonia (EP). Eosinophil degranulation results in the release of their four toxic proteins [major basic protein (MBP), eosinophil cationic protein (ECP), eosinophil peroxidase (EPO), and eosinophil-derived neurotoxin (EDN)] which promote disease pathogenesis. Pancreatitis is the inflammatory disease of the pancreas that arises due to blockage of the pancreatic duct, trypsinogen mutation, alcohol consumption, and repeated occurrence of pancreatitis leading to chronic pancreatitis (CP); subsequently some CP patients may also develop pancreatic cancer. The presence of eosinophils is now shown in various case reports with acute, recurrent acute, and chronic pancreatitis and pancreatic cancer indicating the role of eosinophils in the pathogenesis of various pancreatic inflammatory disorders. However, the details of eosinophil accumulation during pancreatic diseases are not well explored and need further attention. Overall, the chapter provides the current understanding of reported eosinophils associated with inflammatory diseases like EGID diseases, asthma, and pancreatic disorders, i.e., acute, chronic pancreatitis, and pancreatic cancer. This knowledge will be helpful for future studies to develop novel treatment options for the eosinophils associated diseases. Therefore, more efforts are needed to perform preclinical and clinical studies in this field for the successful development of eosinophil-targeting treatments for a variety of eosinophil-associated diseases.


Assuntos
Eosinofilia/patologia , Eosinófilos/patologia , Eosinófilos/fisiologia , Animais , Asma/patologia , Modelos Animais de Doenças , Enterite , Proteínas Granulares de Eosinófilos , Peroxidase de Eosinófilo , Neurotoxina Derivada de Eosinófilo , Eosinofilia/imunologia , Esofagite Eosinofílica/patologia , Gastrite , Humanos , Síndrome Hipereosinofílica/patologia , Inflamação/imunologia , Camundongos , Modelos Biológicos
5.
Am J Clin Pathol ; 155(2): 160-178, 2021 02 04.
Artigo em Inglês | MEDLINE | ID: mdl-33367495

RESUMO

OBJECTIVES: To summarize cases submitted to the 2019 Society for Hematopathology/European Association for Haematopathology Workshop under the category of myeloid/lymphoid neoplasms with eosinophilia and PDGFRA, PDGFRB, or FGFR1 or with PCM1-JAK2 rearrangements, focusing on recent updates and relevant practice findings. METHODS: The cases were summarized according to their respective gene rearrangement to illustrate the spectrum of clinical, laboratory, and histopathology manifestations and to explore the appropriate molecular genetic tests. RESULTS: Disease presentations were heterogeneous, including myeloproliferative neoplasms (MPNs), myelodysplastic syndromes (MDSs), MDS/MPN, acute myeloid leukemia, acute B- or T-lymphoblastic lymphoma/acute lymphoblastic lymphoma (ALL/LBL), or mixed-lineage neoplasms. Frequent extramedullary involvement occurred. Eosinophilia was common but not invariably present. With the advancement of RNA sequencing, cryptic rearrangements were recognized in genes other than PDGFRA. Additional somatic mutations were more frequent in the FGFR1-rearranged cases. Cases with B-ALL presentations differed from Philadelphia-like B-ALL by the presence of an underlying MPN. Cases with FLT3 and ABL1 rearrangements could be potential candidates for future inclusion in this category. CONCLUSIONS: Accurate diagnosis and classification of this category of myeloid/lymphoid neoplasms has important therapeutic implications. With the large number of submitted cases, we expand our understanding of these rare neoplasms and improve our ability to diagnose these genetically defined disorders.


Assuntos
Eosinofilia , Neoplasias Hematológicas , Diagnóstico Diferencial , Eosinofilia/etiologia , Eosinofilia/patologia , Neoplasias Hematológicas/diagnóstico , Neoplasias Hematológicas/genética , Neoplasias Hematológicas/patologia , Humanos , Leucemia Mieloide Aguda/diagnóstico , Leucemia Mieloide Aguda/genética , Leucemia Mieloide Aguda/patologia , Síndromes Mielodisplásicas/diagnóstico , Síndromes Mielodisplásicas/genética , Síndromes Mielodisplásicas/patologia , Proteínas de Fusão Oncogênica/genética , Leucemia-Linfoma Linfoblástico de Células T Precursoras/diagnóstico , Leucemia-Linfoma Linfoblástico de Células T Precursoras/genética , Leucemia-Linfoma Linfoblástico de Células T Precursoras/patologia , Receptor Tipo 1 de Fator de Crescimento de Fibroblastos/genética , Receptor alfa de Fator de Crescimento Derivado de Plaquetas/genética , Receptor beta de Fator de Crescimento Derivado de Plaquetas/genética
6.
Am J Clin Pathol ; 155(2): 179-210, 2021 02 04.
Artigo em Inglês | MEDLINE | ID: mdl-33367563

RESUMO

OBJECTIVES: To report the findings of the 2019 Society for Hematopathology/European Association for Haematopathology Workshop within the categories of reactive eosinophilia, hypereosinophilic syndrome (HES), germline disorders with eosinophilia (GDE), and myeloid and lymphoid neoplasms associated with eosinophilia (excluding entities covered by other studies in this series). METHODS: The workshop panel reviewed 109 cases, assigned consensus diagnosis, and created diagnosis-specific sessions. RESULTS: The most frequent diagnosis was reactive eosinophilia (35), followed by acute leukemia (24). Myeloproliferative neoplasms (MPNs) received 17 submissions, including chronic eosinophilic leukemia, not otherwise specified (CEL, NOS). Myelodysplastic syndrome (MDS), MDS/MPN, and therapy-related myeloid neoplasms received 11, while GDE and HES received 12 and 11 submissions, respectively. CONCLUSIONS: Hypereosinophilia and HES are defined by specific clinical and laboratory criteria. Eosinophilia is commonly reactive. An acute leukemic onset with eosinophilia may suggest core-binding factor acute myeloid leukemia, blast phase of chronic myeloid leukemia, BCR-ABL1-positive leukemia, or t(5;14) B-lymphoblastic leukemia. Eosinophilia is rare in MDS but common in MDS/MPN. CEL, NOS is a clinically aggressive MPN with eosinophilia as the dominant feature. Bone marrow morphology and cytogenetic and/or molecular clonality may distinguish CEL from HES. Molecular testing helps to better subclassify myeloid neoplasms with eosinophilia and to identify patients for targeted treatments.


Assuntos
Eosinofilia , Neoplasias Hematológicas , Síndrome Hipereosinofílica , Leucemia Linfoide , Diagnóstico Diferencial , Eosinofilia/diagnóstico , Eosinofilia/etiologia , Eosinofilia/patologia , Feminino , Proteínas de Fusão bcr-abl/metabolismo , Predisposição Genética para Doença , Células Germinativas/patologia , Neoplasias Hematológicas/diagnóstico , Neoplasias Hematológicas/patologia , Técnicas Histológicas , Humanos , Síndrome Hipereosinofílica/diagnóstico , Síndrome Hipereosinofílica/patologia , Leucemia/diagnóstico , Leucemia/patologia , Leucemia Linfoide/diagnóstico , Leucemia Linfoide/patologia , Leucemia Mielogênica Crônica BCR-ABL Positiva/diagnóstico , Leucemia Mielogênica Crônica BCR-ABL Positiva/patologia , Leucemia Mieloide de Fase Acelerada/diagnóstico , Leucemia Mieloide de Fase Acelerada/patologia , Masculino , Síndromes Mielodisplásicas/diagnóstico , Síndromes Mielodisplásicas/patologia , Patologia Molecular , Leucemia-Linfoma Linfoblástico de Células T Precursoras/diagnóstico , Leucemia-Linfoma Linfoblástico de Células T Precursoras/patologia
8.
Int J Dermatol ; 59(12): 1468-1474, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33040344

RESUMO

BACKGROUND: An association between wearing protective gear and eosinophilic folliculitis has not been reported. We aimed to investigate such during the COVID-19 pandemic. METHODS: In three outpatient clinics, we hand-reviewed records of all patients having consulted us during a Study Period (90 days) in the early phase of the pandemic. Our inclusion criteria for Study Subjects were: (i) clear clinical diagnosis, (ii) dermoscopic confirmation, (iii) differential diagnoses excluded, (iv) eosinophilia, (v) protective gear worn during sanitation services, (vi) temporal correlation, (vii) distributional correlation, (viii) physician-assessed association, and (ix) patient-assessed association. Control Periods in the same season were elected. RESULTS: Twenty-five study subjects fulfilled all inclusion criteria. The incidence was significantly higher than in the control periods (IR: 3.57, 95% CI: 1.79-7.43). Male predominance was significant (P < 0.001). Such for patients in the control periods were insignificant. Study subjects were 21.2 (95% CI: 11.0-31.4) years younger than patients in the control periods. For the study subjects, the distribution of erythematous or skin-colored folliculocentric dome-shaped papules and pustules were all compatible with body parts covered by the gear. Lesional biopsy performed on two patients revealed eosinophilic dermal infiltrates within and around the pilosebaceous units. Polarized dermoscopy revealed folliculitis with peri-/interfollicular vascular proliferation. Lesion onsets were 6.4 (SD: 2.1) days after wearing gear. Remissions were 16.7 (SD: 7.5) days after ceasing to wear gear and treatments. CONCLUSIONS: Wearing protective gear in volunteered sanitizing works could be associated with eosinophilic folliculitis. Owing to the significant temporal and distributional correlations, the association might be causal.


Assuntos
Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/prevenção & controle , Eosinofilia/epidemiologia , Foliculite/epidemiologia , Pandemias/prevenção & controle , Equipamento de Proteção Individual/efeitos adversos , Pneumonia Viral/prevenção & controle , Dermatopatias Vesiculobolhosas/epidemiologia , Voluntários/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus/patogenicidade , Biópsia , Controle de Doenças Transmissíveis/instrumentação , Controle de Doenças Transmissíveis/normas , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Dermoscopia , Diagnóstico Diferencial , Eosinofilia/diagnóstico , Eosinofilia/etiologia , Eosinofilia/patologia , Feminino , Foliculite/diagnóstico , Foliculite/etiologia , Foliculite/patologia , Folículo Piloso/diagnóstico por imagem , Folículo Piloso/patologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Estudos Retrospectivos , Fatores de Risco , Saneamento , Fatores Sexuais , Dermatopatias Vesiculobolhosas/diagnóstico , Dermatopatias Vesiculobolhosas/etiologia , Dermatopatias Vesiculobolhosas/patologia , Fatores de Tempo , Adulto Jovem
9.
Dermatol Online J ; 26(6)2020 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-32815686

RESUMO

Drug rash with eosinophilia and systemic symptoms (DRESS) is a rare delayed drug reaction that often occurs 2-6 weeks after initiation of therapy and may develop into a life-threatening systemic reaction. Besides immediate discontinuation of the suspected inciting drug, initiation of high dose systemic corticosteroids has long been the mainstay of treatment for severe cases. Nevertheless, significant drawbacks associated with systemic corticosteroid therapy, such as the requirement of a long tapering period post resolution and extensive adverse side effects profile, have motivated clinicians to seek alternative treatment options. Over the past decade, an undisputed increasing number of favorable case reports has highlighted cyclosporine as an emerging, safe, and effective alternative despite inconsistent dosing regimens reported. Herein, we report a severe case of vancomycin-induced DRESS syndrome in which the patient failed initial intervention with cyclosporine and needed rescue with methylprednisolone. To the best of our knowledge, this constitutes the first unsuccessful report of cyclosporine treatment for DRESS syndrome.


Assuntos
Ciclosporina/uso terapêutico , Síndrome de Hipersensibilidade a Medicamentos/etiologia , Vancomicina/efeitos adversos , Síndrome de Hipersensibilidade a Medicamentos/tratamento farmacológico , Síndrome de Hipersensibilidade a Medicamentos/patologia , Resistência a Medicamentos , Eosinofilia/induzido quimicamente , Eosinofilia/patologia , Exantema/induzido quimicamente , Feminino , Antebraço/patologia , Humanos
10.
Int. j. morphol ; 38(4): 882-887, Aug. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1124870

RESUMO

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.


Assuntos
Humanos , Masculino , Neoplasias da Próstata/patologia , Próstata/patologia , Neoplasias da Próstata/diagnóstico , Biópsia , Mastocitose/patologia , Biomarcadores Tumorais/análise , Chile , Fatores Etários , Eosinofilia/patologia , Detecção Precoce de Câncer , Gradação de Tumores
12.
J Cancer Res Ther ; 16(3): 581-586, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32719271

RESUMO

Introduction: Eosinophils are multifunctional granulocytes, which play a pivotal role in health and disease. Tumor Associated Tissue Eosinophilia (TATE) has long been evaluated in the diagnosis and progression of oral squamous cell carcinomas (OSCCs). However, their association with Tumor Associated Blood Eosinophilia (TABE) in OSCCs is still far fetched. We, therefore, attempted to evaluate their individual roles and to achieve a ratio between TATE and TABE in order to signify its usage in objectifying the diagnosis. Materials and Methods: TATE was evaluated using H and E stain per 10 high power fields in 33 previously diagnosed cases of OSCC which were retrieved from department archives. TABE values were achieved from complete blood hemogram reports of patients. TATE/TABE ratio was calculated. All the parameters were clinicopathologically correlated and statistically evaluated using SPSS. Results: TATE represented higher values in well-differentiated squamous cell carcinoma (WDSCC) and poorly differentiated squamous cell carcinoma (PDSCC) and was least in moderately differentiated squamous cell carcinoma (MDSCC), whereas TABE linearly increased from WDSCC to PDSCC. TNM Stage II cases revealed the highest TATE and lowest TABE. TATE/TABE ratio was the highest in WDSCC. Conclusion: Due to the dual nature of eosinophils in early and late carcinogenesis events, evaluation of only TATE might not be conclusive in determining tumor grade. Hence, in a first of its kind attempt, the TATE/TABE ratio may be suitable to achieve a criterion for the determination of tumor grade and may also help to unfold the underlying biologic events.


Assuntos
Eosinofilia/patologia , Eosinófilos/patologia , Neoplasias Bucais/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Diagnóstico Diferencial , Eosinofilia/diagnóstico , Eosinofilia/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/sangue , Gradação de Tumores , Estadiamento de Neoplasias , Estudos Retrospectivos , Carcinoma de Células Escamosas de Cabeça e Pescoço/sangue , Coloração e Rotulagem/métodos
13.
Dermatol Online J ; 26(3)2020 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-32609451

RESUMO

Eosinophilic dermatosis of hematologic malignancy (EDHM) is a dermatosis characterized by tissue eosinophilia that has been previously reported as insect bite-like reaction. It is a rare condition with a wide variety of clinical presentations ranging from papules, nodules, or blisters that simulate arthropod bites, to the formation of plaques of differing sizes. We report a case of eosinophilic dermatosis of hematologic malignancy in a patient with a hematoproliferative disorder.


Assuntos
Eosinofilia/patologia , Síndromes Mielodisplásicas/complicações , Síndromes Paraneoplásicas/patologia , Dermatopatias/patologia , Idoso , Eosinofilia/etiologia , Humanos , Masculino , Dermatopatias/etiologia
15.
Clin Sci (Lond) ; 134(11): 1191-1218, 2020 06 12.
Artigo em Inglês | MEDLINE | ID: mdl-32432676

RESUMO

Myocardial infarction (MI) is the leading cause of mortality worldwide. Interleukin (IL)-33 (IL-33) is a cytokine present in most cardiac cells and is secreted on necrosis where it acts as a functional ligand for the ST2 receptor. Although IL-33/ST2 axis is protective against various forms of cardiovascular diseases, some studies suggest potential detrimental roles for IL-33 signaling. The aim of the present study was to examine the effect of IL-33 administration on cardiac function post-MI in mice. MI was induced by coronary artery ligation. Mice were treated with IL-33 (1 µg/day) or vehicle for 4 and 7 days. Functional and molecular changes of the left ventricle (LV) were assessed. Single cell suspensions were obtained from bone marrow, heart, spleen, and peripheral blood to assess the immune cells using flow cytometry at 1, 3, and 7 days post-MI in IL-33 or vehicle-treated animals. The results of the present study suggest that IL-33 is effective in activating a type 2 cytokine milieu in the damaged heart, consistent with reduced early inflammatory and pro-fibrotic response. However, IL-33 administration was associated with worsened cardiac function and adverse cardiac remodeling in the MI mouse model. IL-33 administration increased infarct size, LV hypertrophy, cardiomyocyte death, and overall mortality rate due to cardiac rupture. Moreover, IL-33-treated MI mice displayed a significant myocardial eosinophil infiltration at 7 days post-MI when compared with vehicle-treated MI mice. The present study reveals that although IL-33 administration is associated with a reparative phenotype following MI, it worsens cardiac remodeling and promotes heart failure.


Assuntos
Eosinófilos/metabolismo , Ventrículos do Coração/patologia , Ventrículos do Coração/fisiopatologia , Interleucina-33/farmacologia , Infarto do Miocárdio/fisiopatologia , Sístole/efeitos dos fármacos , Remodelação Ventricular/efeitos dos fármacos , Animais , Apoptose/efeitos dos fármacos , Citocinas/sangue , Fragmentação do DNA/efeitos dos fármacos , Diástole/efeitos dos fármacos , Eosinofilia/patologia , Eosinófilos/efeitos dos fármacos , Fibrose , Ventrículos do Coração/efeitos dos fármacos , Hipertrofia Ventricular Esquerda/patologia , Mediadores da Inflamação/sangue , Interleucina-33/administração & dosagem , Masculino , Metaloproteinase 2 da Matriz/metabolismo , Metaloproteinase 9 da Matriz/metabolismo , Camundongos Endogâmicos C57BL , Infarto do Miocárdio/enzimologia , Infarto do Miocárdio/genética , Infarto do Miocárdio/patologia , Neutrófilos/efeitos dos fármacos , Neutrófilos/metabolismo , Fenótipo , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Esplenomegalia/patologia , Regulação para Cima/efeitos dos fármacos , Remodelação Ventricular/genética , Proteína X Associada a bcl-2/genética , Proteína X Associada a bcl-2/metabolismo
16.
Ann Allergy Asthma Immunol ; 125(3): 304-310.e1, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32387168

RESUMO

BACKGROUND: Predicting postoperative olfactory decline in patients with chronic rhinosinusitis (CRS) remains a considerable challenge. OBJECTIVE: To evaluate patterns of postoperative olfactory function in patients with CRS and explore potential predictors of postoperative olfactory decline. METHODS: A total of 76 patients with CRS electing endoscopic sinus surgery (ESS) were enrolled in this prospective study. Olfaction was assessed with Sniffin' Sticks preoperatively and 3 months postoperatively. Preoperative peripheral venous blood and superior turbinate at surgery were collected for eosinophil quantification. Olfactory cleft was evaluated by computed tomography and endoscopy. Postoperative olfactory decline was defined by a decrease in threshold-discrimination-identification (TDI) score more than 0 point. Multivariable logistic regression analysis was conducted to identify potential predictors associated with postoperative olfactory decline in TDI score. RESULTS: A total of 30.26% of patients with CRS (23/76) presented with olfactory decline 3 months post-ESS. Patients with CRS with olfactory decline showed significantly higher preoperative tissue eosinophils (P < .001), blood eosinophil count (P = .002), blood eosinophil percentage (P = .009), and preoperative TDI scores (P = .017) than patients with CRS without olfactory decline. After adjusting for patient demographics and comorbidities, the preoperative tissue eosinophilia was significantly associated with patients with CRS with postoperative olfactory decline (odds ratio = 1.103; P = .038). An absolute count of 23.5 eosinophils per high-power field in superior turbinate was the best predictor of olfactory decline with the highest area under the receiver operating characteristic curve of 0.901. CONCLUSION: Superior turbinate eosinophilia is highly associated with olfactory decline in patients with CRS 3 months after ESS.


Assuntos
Eosinofilia/etiologia , Transtornos do Olfato/etiologia , Complicações Cognitivas Pós-Operatórias/etiologia , Rinite/etiologia , Sinusite/complicações , Conchas Nasais/patologia , Doença Crônica , Endoscopia/métodos , Eosinofilia/patologia , Eosinófilos/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pólipos Nasais/patologia , Transtornos do Olfato/patologia , Complicações Cognitivas Pós-Operatórias/patologia , Período Pré-Operatório , Rinite/patologia , Sinusite/patologia , Sinusite/cirurgia , Olfato/fisiologia
17.
Arq Gastroenterol ; 57(1): 74-78, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32294739

RESUMO

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.


Assuntos
Duodeno/patologia , Dispepsia/microbiologia , Eosinofilia/patologia , Mucosa Gástrica/patologia , Infecções por Helicobacter/patologia , Helicobacter pylori , Adulto , Biópsia , Estudos de Casos e Controles , Duodeno/microbiologia , Dispepsia/patologia , Feminino , Mucosa Gástrica/microbiologia , Gastroscopia , Humanos , Masculino , Pessoa de Meia-Idade
19.
Dermatol Online J ; 26(2)2020 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-32239898

RESUMO

A 60-year old man developed skin hardening and edema on his extremities. Although he had been treated with oral prednisolone at another hospital, skin stiffness relapsed during tapering of prednisolone. At the initial visit to our department, physical examination showed skin hardening of the extremities and also symmetric erythematous macules on the back. Histological examination revealed fasciitis on the forearm and morphea on the back. Eosinophilic fasciitis is occasionally associated with morphea. However, cases of concurrent eosinophilic fasciitis and generalized morphea are rare. In the present case, CD34 was differentially expressed in both lesions, suggesting eosinophilic fasciitis and morphea are separate diseases with different origin of mesenchymal cells.


Assuntos
Eosinofilia/complicações , Fasciite/complicações , Escleroderma Sistêmico/complicações , Adulto , Idoso , Antígenos CD34/metabolismo , Eosinofilia/tratamento farmacológico , Eosinofilia/patologia , Fasciite/tratamento farmacológico , Fasciite/patologia , Feminino , Glucocorticoides/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Prednisolona/uso terapêutico , Escleroderma Sistêmico/tratamento farmacológico , Escleroderma Sistêmico/patologia
20.
Trop Doct ; 50(3): 277-279, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32178592

RESUMO

Eosinophilic ascites, owing to serosal involvement, is a very rare manifestation of eosinophilic gastroenteritis in children, especially when it occurs with muscular involvement in the absence of mucosal disease, which may be confirmed by endoscopic ultrasonography. An 11-year-old girl, presenting with massive eosinophilic ascites and colicky abdominal pain with peripheral eosinophilia, raised IgE levels and positive skin prick test, had such investigation which confirmed the presence of muscle layer thickening of both stomach and small bowel. She responded well to steroids and montelukast.


Assuntos
Ascite/diagnóstico , Enterite/diagnóstico , Eosinofilia/diagnóstico , Gastrite/diagnóstico , Músculos Abdominais/diagnóstico por imagem , Músculos Abdominais/patologia , Ascite/tratamento farmacológico , Ascite/patologia , Criança , Endossonografia , Enterite/tratamento farmacológico , Enterite/patologia , Eosinofilia/tratamento farmacológico , Eosinofilia/patologia , Eosinófilos/patologia , Feminino , Gastrite/tratamento farmacológico , Gastrite/patologia , Humanos , Esteroides/uso terapêutico , Resultado do Tratamento
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