Involvement of peripheral mast cells in a fibromyalgia model in mice.

Fibromyalgia is a painful disorder of unknown aetiology that presents activation and recruitment of innate immune cells, including mast cells. Efforts have been made to understand its pathogenesis to manage it better. Thus, we explored the involvement of peripheral mast cells in an experimental model of fibromyalgia induced by reserpine. Reserpine (1 mg/kg) was subcutaneously (s.c.) injected once daily in the back of male Swiss mice for three consecutive days. We analysed mechanical and cold allodynia, muscle fatigue and number of mast cell in plantar tissue. The fibromyalgia induction produced mast cell infiltration (i.e., mastocytosis) in the mice's plantar tissue. The depletion of mast cell mediators with the compound 48/80 (0.5-4 mg/kg, intraperitoneal (i.p.)) or the mast cell membrane stabilizer ketotifen fumarate (10 mg/kg, oral route (p.o.) widely (80-90 %) and extensively (from 1 up to 10 days) prevented reserpine-induced mechanical and cold allodynia and muscle fatigue. Compound 48/80 also prevented the reserpine-induced mastocytosis. Finally, we demonstrated that PAR-2, 5-HT2A, 5-HT3, H1, NK1 and MrgprB2 receptors, expressed in neuronal or mast cells, seem crucial to mediate fibromyalgia-related cardinal symptoms since antagonists or inhibitors of these receptors (gabexate (10 mg/kg, s.c.), ENMD-1068 (10 mg/kg, i.p.), ketanserin (1 mg/kg, i.p.), ondansetron (1 mg/kg, p.o.), promethazine (1 mg/kg, i.p.), and L733,060 (5 mg/kg, s.c.), respectively) transiently reversed the reserpine-induced allodynia and fatigue. The results indicate that mast cells mediate painful and fatigue behaviours in this fibromyalgia model, representing potential therapy targets to treat fibromyalgia syndrome.

Mastocitose sistêmica: visão do dermatologista e relato de um caso associado a líquen plano / Systemic mastocytosis: a dermatologist's view and report of a case associated with lichen planus

Contexto: A mastocitose ocorre devido a uma proliferação neoplásica e clonal de mastócitos que se acumulam em um ou mais sistemas de órgãos. A doença é heterogênea, com manifestações que vão desde lesões cutâneas que podem regredir espontaneamente até neoplasias altamente agressivas associadas à falência de múltiplos órgãos e baixa sobrevida. Não há relatos na literatura de sua associação com líquen plano. Descrição do caso: Relatamos o caso de uma paciente com diagnóstico de mastocitose sistêmica agressiva que apresentou durante o acompanhamento quadro compatível com líquen plano. Discussão: O diagnóstico da mastocitose sistêmica é baseado em critérios que foram refinados recentemente. O tratamento classicamente envolve bloqueio de mediadores de mastócitos e terapia citorredutora para variantes avançadas da doença. Novas drogas como a midostaurina e o avapritinibe são promissoras. Conclusões: Mesmo não fazendo parte da rotina do dermatologista, a mastocitose sistêmica deve ser uma doença lembrada pelo acometimento da pele e potencial gravidade do quadro.

Mastocitoma cutâneo canino após mastocitose acidental induzida por opioide: Relato de caso / Canine cutaneous mastocytoma after accidental opioid-induced mastocytosis: Case report

A aproximação entre petse tutores está cada vez mais presente na rotina atual das residências familiares. Essa aproximação aumenta a observação de quaisquer alterações físicas ou comportamentais dos animais levando-o a buscar um médico veterinário quando necessário. O papel do clínico, oncologista e do patologista veterinário vem a ser de extrema importância para detecção das neoplasias em suas fases iniciais. A utilização dos meios de diagnósticos complementares para os casos de neoplasias é de fundamental importância para ter ciência do prognóstico do animal e de qual tratamento será o melhor tratamento para os casos abordados. O mastocitoma é a neoplasia cutânea mais frequente do cão, é uma neoplasia maligna e sua etiologia é pouco compreendida. Independente do sexo, atingem machos e fêmeas, porém se apresentam de forma mais agressiva em machos. O diagnóstico, geralmente é estabelecido por meio de exames complementares, associados aos sinaisclínicos, devendo sempre prezar pelo diagnóstico precoce para que haja maior êxito no tratamento.O exame citológico para o diagnóstico de mastocitoma é um dos métodos mais eficientes e de baixo custo, sendo complementado pelo exame histopatológico para agraduação de malignidade e estadiamento da doença. Preconiza-se a associação da cirurgia com o tratamento quimioterápico com terapia antiblástica e eletroquimioterapia para um melhor prognóstico. O objetivo deste trabalho foi relatar um caso de mastocitoma cutâneo após um erro primário de manejo clinico, em um canino, macho, nove anos, da raça American Pitbull Terrier, trazendo sua complexidade e bases dos meios de diagnóstico(AU)

The approximation between pets and tutors is increasingly present in the current routine of family homes. This approach increases the observation of physical or behavioral changes in animals, leading them to seek a veterinarian when necessary. The role of the clinician, oncologist and veterinary pathologist is extremely important for the detection of neoplasms in their early stages. The use of complementary diagnostic means for cases of neoplasms is of fundamental importance to be aware of the animal's prognosis and which treatment will be the best treatment for the cases examined. Mastocytoma is the most frequent skin neoplasm in dogs, it is a malignant neoplasm and its etiology is poorly understood. Regardless of gender, they affect males and females, but are more aggressive in males. The diagnosis is usually established through complementary exams, associated with clinical signs. Cytological examination for the diagnosis of mast cell tumor is an inexpensive method and one of the most efficient methods, being complemented by histopathological examination for its evolution of malignancy and disease staging, recommended the association of surgery with chemotherapy treatment with antiblastic therapy and electrochemotherapy for better prognoses. The aim of this study was to report a case of cutaneous mastocytoma after a primary error in clinical management, in a canine, male, nine years old, of the American Pitbull Terrier breed, bringing its complexity and bases of the means of diagnosis(AU)

Effect of a Cytoprotective Dose of Dehydroleucodine, Xanthatin, and 3-Benzyloxymethyl-5H-furan-2-one on Gastric Mucosal Lesions Induced by Mast Cell Activation.

The aim of this study was to determine whether the lactones dehydroleucodine, xanthatin and 3-benzyloxymethyl-5H-furan-2-one, would be effective in an animal model of gastric ulcer induced by mast cell activation. Rats were divided into ten groups. Treatments were repeated for four days. The degree of gastric erosion was assessed with a scoring system and histological preparations. Gastric mast cell morphology was analyzed by histological procedures. Serum serotonin levels were determined as markers of mast cell activation. Statistical analyses were done using ANOVA and Tukey-Kramer test. We demonstrated that the repeated administration of compound 48/80 results in extensive mucosal lesions in the gastric mucosa and that such lesions occurred in association with mast cell degranulation and a significant increase of serum serotonin. We showed that these lesions were prevented by dehydroleucodine, xanthatin, and 3-benzyloxymethyl-5H-furan-2-one and that this effect was similar to that obtained with sodium cromoglycate. In conclusion, the results of the present study indicate that the optimal gastric cytoprotective dose of dehydroleucodine, xanthatin, and 3-benzyloxymethyl-5H-furan-2-one is efficacious in an animal model of gastric ulcer induced by mast cell activation. Our findings suggest that these lactones could be valuable tools for designing novel therapeutic agents for digestive disorders associated with inappropriate mast cell activation.

[Update on perioperative hypersensitivity reactions: joint document from the Brazilian Society of Anesthesiology (SBA) and Brazilian Association of Allergy and Immunology (ASBAI) - Part II: etiology and diagnosis]. / Atualização sobre reações de hipersensibilidade perioperatória: documento conjunto da Sociedade Brasileira de Anestesiologia (SBA) e Associação Brasileira de Alergia e Imunologia (ASBAI) ­ Parte II: etiologia e diagnóstico.

This second joint document, written by experts from the Brazilian Association of Allergy and Immunology (ASBAI) and Brazilian Society of Anesthesiology (SBA) concerned with perioperative anaphylaxis, aims to review the pathophysiological reaction mechanisms, triggering agents (in adults and children), and the approach for diagnosis during and after an episode of anaphylaxis. As anaphylaxis assessment is extensive, the identification of medications, antiseptics and other substances used at each setting, the comprehensive data documentation, and the use of standardized nomenclature are key points for obtaining more consistent epidemiological information on perioperative anaphylaxis.

Update on perioperative hypersensitivity reactions: joint document from the Brazilian Society of Anesthesiology (SBA) and Brazilian Association of Allergy and Immunology (ASBAI) - Part II: etiology and diagnosis / Atualização sobre reações de hipersensibilidade perioperatória: documento conjunto da Sociedade Brasileira de Anestesiologia (SBA) e Associação Brasileira de Alergia e Imunologia (ASBAI) - Parte II: etiologia e diagnóstico

Abstract This second joint document, written by experts from the Brazilian Association of Allergy and Immunology (ASBAI) and Brazilian Society of Anesthesiology (SBA) concerned with perioperative anaphylaxis, aims to review the pathophysiological reaction mechanisms, triggering agents (in adults and children), and the approach for diagnosis during and after an episode of anaphylaxis. As anaphylaxis assessment is extensive, the identification of medications, antiseptics and other substances used at each setting, the comprehensive data documentation, and the use of standardized nomenclature are key points for obtaining more consistent epidemiological information on perioperative anaphylaxis.

Resumo Este segundo documento, escrito por especialistas da Associação Brasileira de Alergia e Imunologia (ASBAI) e da Sociedade Brasileira de Anestesiologia (SBA) interessados no tema anafilaxia perioperatória, tem por objetivo revisar os mecanismos fisiopatológicos, agentes desencadeantes (em adultos e crianças), assim como a abordagem diagnóstica durante e após o episódio. Por se tratar de uma avaliação abrangente, a identificação das medicações, antissépticos e outras substâncias usadas em cada região, registros detalhados, e nomenclatura padronizada são pontos fundamentais para a obtenção de dados epidemiológicos mais fidedignos sobre a anafilaxia perioperatória.

Epidemiology of Canine Mast Cell Tumors in Uruguay

We examined in the present study main epidemiological features of canine mast cell tumors in Uruguay, principal breeds of occurrence, age, gender, anatomical distributions, and associated differences of pathological grading. During a three-year period, eighty four out of 405 skin specimens of dogs mainly received at the Veterinary Faculty of Montevideo from private clinics were mast cell tumors. Mix-breed dogs were mostly affected, followed by Labrador Retrievers, Boxers, Pit bulls and Golden Retrievers. Age of patients ranged from 3 to 15 years (median 7.9), and the incidence in females was slightly higher than in males. Tumors were more frequent in the trunk, followed by extremities, scrotum and neck. The majority of specimens were of high malignancy.(AU)

Epidemiology of Canine Mast Cell Tumors in Uruguay

We examined in the present study main epidemiological features of canine mast cell tumors in Uruguay, principal breeds of occurrence, age, gender, anatomical distributions, and associated differences of pathological grading. During a three-year period, eighty four out of 405 skin specimens of dogs mainly received at the Veterinary Faculty of Montevideo from private clinics were mast cell tumors. Mix-breed dogs were mostly affected, followed by Labrador Retrievers, Boxers, Pit bulls and Golden Retrievers. Age of patients ranged from 3 to 15 years (median 7.9), and the incidence in females was slightly higher than in males. Tumors were more frequent in the trunk, followed by extremities, scrotum and neck. The majority of specimens were of high malignancy.

Update on perioperative hypersensitivity reactions: joint document of the Brazilian Society of Anesthesiology (SBA) and Brazilian Association of Allergy and Immunology (ASBAI) - Part I: post-crisis guidelines and treatment / Atualização sobre reações de hipersensibilidade perioperatória: documento conjunto da Sociedade Brasileira de Anestesiologia (SBA) e Associação Brasileira de Alergia e Imunologia (ASBAI) - Parte I: tratamento e orientação pós-crise

Abstract Experts from the Brazilian Association of Allergy and Immunology (ASBAI) and the Brazilian Society of Anesthesiology (SBA) interested in the issue of perioperative anaphylaxis, and aiming to strengthen the collaboration between the two societies, combined efforts to study the topic and to prepare a joint document to guide specialists in both areas. The purpose of the present series of two articles was to report the most recent evidence based on the collaborative assessment between both societies. This first article will consider the updated definitions, treatment and guidelines after a perioperative crisis. The following article will discuss the major etiologic agents, how to proceed with the investigation, and the appropriate tests.

Resumo Especialistas da Associação Brasileira de Alergia e Imunologia (ASBAI) e da Sociedade Brasileira de Anestesiologia (SBA) interessados no tema anafilaxia perioperatória reuniram-se com o objetivo de intensificar a colaboração entre as duas sociedades no estudo desse tema e elaborar um documento conjunto que possa guiar os especialistas de ambas as áreas. O objetivo desta série de dois artigos foi mostrar as evidências mais recentes alicerçadas na visão colaborativa entre as sociedades. Este primeiro artigo versará sobre as definições mais atuais, formas de tratamento e as orientações após a crise no perioperatório. No próximo artigo serão discutidos os principais agentes causais e a condução da investigação com testes apropriados.

Morphological changes of the cellularity in the prostatic gland from patients with confirmed cancer: Gleason level and presence of eosinophils and mast cells: cellular bioindicators / Cambios morfológicos de la celularidad en la glándula prostática de pacientes con cáncer confirmado: nivel de gleason y presencia de eosinófilos y mastocitos: bioindicadores celulares

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.

Atualização sobre reações de hipersensibilidade perioperatória: Documento conjunto da Sociedade Brasileira de Anestesiologia e Associação Brasileira de Alergia e Imunologia ­ Parte II: etiologia e diagnóstico / Update on perioperative hypersensitivity reactions: Joint document from the Brazilian Society of Anesthesiology and Brazilian Association of Allergy and Immunology ­ Part II: Etiology and diagnosis

A anafilaxia perioperatória é manifestação importante no contexto de eventos adversos relacionados à cirurgia. Embora frequentemente relacionada à indução anestésica, pode ocorrer por outros agentes administrados por outras vias. A anafilaxia pode se apresentar como colapso cardiovascular, obstrução da via aérea e/ou insuficiência respiratória com ou sem manifestação cutânea, com consequências fatais em muito casos. Apesar de considerada inevitável em alguns casos, a sua incidência poderia (e deveria) ser reduzida através da busca por fármacos mais seguros. A avaliação abrangente de um episódio é um dos elementos primordiais para tornar a exposição subsequente mais segura, com orientações derivadas dessa investigação. Entretanto, representa um desafio estatístico por ser reação rara, randômica e muitas vezes independente de exposições sucessivas dos pacientes a procedimentos de baixo risco. Neste documento são revisados os mecanismos fisiopatológicos, agentes desencadeantes (adultos e crianças), assim como a abordagem diagnóstica durante a crise e após o episódio. Uma avaliação abrangente, a identificação das medicações, antissépticos e outras substâncias usadas em cada região, registros detalhados e nomenclatura padronizada são pontos fundamentais para a obtenção de dados epidemiológicos mais fidedignos sobre a anafilaxia perioperatória.

Perioperative anaphylaxis is an important manifestation in the context of surgery-related adverse events. Although often related to anesthetic induction, it may be caused by other agents administered by other routes. Anaphylaxis may manifest as cardiovascular collapse, airway obstruction and/or respiratory failure with or without skin manifestation, resulting often in death. Although this reaction is considered inevitable in some cases, its incidence could (and should) be reduced by the search for safer drugs. Comprehensive assessment of an allergic reaction is a key element to make subsequent exposure safer, with guidance derived from this investigation. However, surveillance of perioperative anaphylaxis represents a statistical challenge because this is a rare, random reaction and often independent of successive patient exposures to low-risk procedures. This paper reviews pathophysiological mechanisms, triggering agents (adults and children), as well as therapeutic and diagnostic approach during and after an allergic reaction. Comprehensive assessment, identification of medications/antiseptics used in each region and detailed records with standardized terminology are key points for obtaining more reliable epidemiological data on perioperative anaphylaxis.

Escabiose mascarada por mastocitose sistêmica / Scabies masked by systemic mastocytosis

Paciente do sexo feminino, com 59 anos de idade, portadora de mastocitose sistêmica há 20 anos. A mastocitose é doença rara, caracterizada pela proliferação excessiva e o subsequente acúmulo de mastócitos em órgãos e tecidos, principalmente na medula óssea, pele e no trato gastrointestinal. Há 1 mês, relatava história de novas lesões cutâneas caracterizadas por pápulas e placas eritemato-edematosas com escoriação e intenso prurido. Feito o raspado da pele com confirmação diagnóstica de escabiose.

A 59-year-old female patient had a diagnosis of systemic mastocytosis for 20 years. Mastocytosis is a rare disease characterized by excessive proliferation and accumulation of mast cells in organs and tissues, especially in the bone marrow, skin and gastrointestinal tract. She reported new skin lesions characterized by erythematous papules and plaques with excoriation and intense itching for one month. Skin scraping confirmed the diagnosis of scabies.

Mastocitoma solitario ampollar / Solitary Blister Mastocytoma

La mastocitosis comprende un conjunto de desórdenes con expansión anormal y acumulación de mastocitos en diversos órganos incluida la piel, en la cual se describen distintas formas clínicas de presentación. El mastocitoma cutáneo solitario constituye el 10-15% de todas las mastocitosis. Presentamos el caso de un niño con mastocitoma cutáneo solitario ampollar, un cuadro infrecuente cuyo diagnóstico oportuno constituye un reto para pediatras y dermatólogos (AU)

Mastocytosis comprises a set of disorders with abnormal expansion and accumulation of mast cells in various organs including the skin, wich describes different form of clinical presentation. The solitary cutaneous mastocytoma constitutes 10-15 % of all mastocytosis. We present the case of a child with solitary blistering mastocytoma, an infrequent condition whose, timely diagnosis constitutes a challenge for pediatricians and dermatologists (AU)

Mastocitoma de alto grau em bolsa testitular em cão / Mast cell tumor high grade in testicular bag in dog

Mast cell tumor is the most common skin tumor in dogs. Due to mast cell proliferation, the affected animals present clinical symptoms compatible with the release of excess histamine granules present inside these cells leading to changes in the gastrointestinal and vascular tracts with the possibility of causing anaphylactic shock. The diagnosis is made by cytopathological analysis and classified by means of histopathology. Treatment is based on staging, surgical exeresis with antineoplastic chemotherapy and drug treatment to inhibit the effects of histamine release. A dog of 14 years old of Boxer breed was attend complaining of nodulation in the testicular bag with a two month evolution. Animal was diagnosed with mast cell tumor. Treatment was instituted by surgical excision and due to the metastatic possibility in regional lymph node, antineoplastic and drug therapy was indicated, which was not successful due of the person responsible non-adherence to the treatment. Mast cell tumor classified as high grade after histopathological analysis. Animal survived for two months after diagnosis of the disease. Due to the high grade of neoplastic presentation and difficulty in treatment, the animal had low survival, corroborating with data described in the literature regarding the poor prognosis of this tumor type.

Mastocitoma de alto grau em bolsa testitular em cão / Mast cell tumor high grade in testicular bag in dog

Mast cell tumor is the most common skin tumor in dogs. Due to mast cell proliferation, the affected animals present clinical symptoms compatible with the release of excess histamine granules present inside these cells leading to changes in the gastrointestinal and vascular tracts with the possibility of causing anaphylactic shock. The diagnosis is made by cytopathological analysis and classified by means of histopathology. Treatment is based on staging, surgical exeresis with antineoplastic chemotherapy and drug treatment to inhibit the effects of histamine release. A dog of 14 years old of Boxer breed was attend complaining of nodulation in the testicular bag with a two month evolution. Animal was diagnosed with mast cell tumor. Treatment was instituted by surgical excision and due to the metastatic possibility in regional lymph node, antineoplastic and drug therapy was indicated, which was not successful due of the person responsible non-adherence to the treatment. Mast cell tumor classified as high grade after histopathological analysis. Animal survived for two months after diagnosis of the disease. Due to the high grade of neoplastic presentation and difficulty in treatment, the animal had low survival, corroborating with data described in the literature regarding the poor prognosis of this tumor type.(AU)

Características clínicas, histopatológicas e imuno-histoquímicas do mastocitoma cutâneo equino: relato de caso / Clinical, histopathological and immunohistochemical chacteristics ofequine cutaneous mastocytoma: case report

Uma égua puro sangue árabe, com 3 anos de idade, pertencente ao rebanho experimental da FMVZ-USP apresentou lesões tumorais cutâneas nos membros pélvicos direito e esquerdo com aproximadamente um ano de evolução. Notou-se nova formação cutânea com crescimento rápido na região do pescoço, e desde então, as lesões dos membros ganharam características inflamatórias. Foi realizada punção aspirativa da lesão do pescoço para análise citológica, em que se identificou infiltrado eosinofílico. Optou-se pelo início de tratamento conservativo com três infiltrações intralesionais consecutivas com corticoesteroide. A partir da falta de sucesso das infiltrações foram realizadas as excisões cirúrgicas totais dos nódulos do pescoço, membro pélvico direito e esquerdo. Todos os materiais obtidos dos procedimentos cirúrgicos foram enviados para avaliação histopatológica e imuno-histoquímica, nas quais se confirmou o diagnóstico de mastocitoma cutâneo. O animal recebeu alta após a cicatrização das feridas cirúrgicas e remissão dos sinais, e não demonstrou recidivas ou outras complicações advindas das lesões tumorais. Algumas neoplasias cutâneas são bem descritas e de comum ocorrência na espécie equina, como o sarcoide, melanoma, papiloma e tumor de células escamosas. Já o mastocitoma cutâneo consiste em neoplasia cutânea rara nessa espécie. Segundo a literatura, não parece existir uma predileção racial para o aparecimento deste tumor, entretanto, alguns autores citam o acometimento maior nos animais Puro Sangue Árabe. Para o estabelecimento do diagnóstico definitivo é importante a associação dos exames físico, histopatológico e imuno-histoquímico e, apesar desta neoplasia ser de raro aparecimento nos equinos, deve ser sempre considerada como diagnóstico diferencial.(AU)

A 3 year-old mare, Arab, that belongs to the experimental herd of FMVZ-USP presented cutaneous tumor lesions on right and left posterior limb with approximately one year of evolution. A new formation with rapid growth was observed on the neck region, and since then, the limbs lesion gained inflammatory characteristics. Aspirative punction was performed on the neck formation in order to submit the sample to cytological analyses, in which eosinophilic infiltrate was identified. At this point, a conservative approach was chosen with three consecutive corticoid infiltrations. With lack of success of infiltrative therapy, neck, right and left posterior limbs lesions were surgically removed. The materials obtained from surgical procedures were sent to histophatological and immunohistrochemical evaluation that confirmed cutaneous mastocytoma diagnosis. The mare was discharged after all surgical wound were healed and after full remission of clinical signs, and did not show relapses or any other complication from tumor lesions. Some cutaneous tumors are well described and commonly occur in horses, such as sarcoids, melanoma, papilloma and squamous cell carcinoma. Cutaneous mastocytoma is considered a rare cutaneous tumor in this species. According to literature, equine mastocytoma do not have breed predilection, however, some authors mention a greater involvement in Purebreed Arabian horses. In order to establish a definitive diagnosis, it is important to associate physical exams to histophatological an immunohistochemical evaluation and, even though rare in horses, this neoplasm must be considered as a differential diagnosis.(AU)

Características clínicas, histopatológicas e imuno-histoquímicas do mastocitoma cutâneo equino: relato de caso / Clinical, histopathological and immunohistochemical chacteristics ofequine cutaneous mastocytoma: case report

Uma égua puro sangue árabe, com 3 anos de idade, pertencente ao rebanho experimental da FMVZ-USP apresentou lesões tumorais cutâneas nos membros pélvicos direito e esquerdo com aproximadamente um ano de evolução. Notou-se nova formação cutânea com crescimento rápido na região do pescoço, e desde então, as lesões dos membros ganharam características inflamatórias. Foi realizada punção aspirativa da lesão do pescoço para análise citológica, em que se identificou infiltrado eosinofílico. Optou-se pelo início de tratamento conservativo com três infiltrações intralesionais consecutivas com corticoesteroide. A partir da falta de sucesso das infiltrações foram realizadas as excisões cirúrgicas totais dos nódulos do pescoço, membro pélvico direito e esquerdo. Todos os materiais obtidos dos procedimentos cirúrgicos foram enviados para avaliação histopatológica e imuno-histoquímica, nas quais se confirmou o diagnóstico de mastocitoma cutâneo. O animal recebeu alta após a cicatrização das feridas cirúrgicas e remissão dos sinais, e não demonstrou recidivas ou outras complicações advindas das lesões tumorais. Algumas neoplasias cutâneas são bem descritas e de comum ocorrência na espécie equina, como o sarcoide, melanoma, papiloma e tumor de células escamosas. Já o mastocitoma cutâneo consiste em neoplasia cutânea rara nessa espécie. Segundo a literatura, não parece existir uma predileção racial para o aparecimento deste tumor, entretanto, alguns autores citam o acometimento maior nos animais Puro Sangue Árabe. Para o estabelecimento do diagnóstico definitivo é importante a associação dos exames físico, histopatológico e imuno-histoquímico e, apesar desta neoplasia ser de raro aparecimento nos equinos, deve ser sempre considerada como diagnóstico diferencial.

A 3 year-old mare, Arab, that belongs to the experimental herd of FMVZ-USP presented cutaneous tumor lesions on right and left posterior limb with approximately one year of evolution. A new formation with rapid growth was observed on the neck region, and since then, the limbs lesion gained inflammatory characteristics. Aspirative punction was performed on the neck formation in order to submit the sample to cytological analyses, in which eosinophilic infiltrate was identified. At this point, a conservative approach was chosen with three consecutive corticoid infiltrations. With lack of success of infiltrative therapy, neck, right and left posterior limbs lesions were surgically removed. The materials obtained from surgical procedures were sent to histophatological and immunohistrochemical evaluation that confirmed cutaneous mastocytoma diagnosis. The mare was discharged after all surgical wound were healed and after full remission of clinical signs, and did not show relapses or any other complication from tumor lesions. Some cutaneous tumors are well described and commonly occur in horses, such as sarcoids, melanoma, papilloma and squamous cell carcinoma. Cutaneous mastocytoma is considered a rare cutaneous tumor in this species. According to literature, equine mastocytoma do not have breed predilection, however, some authors mention a greater involvement in Purebreed Arabian horses. In order to establish a definitive diagnosis, it is important to associate physical exams to histophatological an immunohistochemical evaluation and, even though rare in horses, this neoplasm must be considered as a differential diagnosis.

[Duodenal eosinophilia in functional dyspepsia in a Colombian sample: a case-control study]. / Eosinofilia duodenal en pacientes Colombianos con dispepsia funcional: un estudio de casos y controles.

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.