RESUMO
Eosinophils are nonspecific harbingers of esophageal disease. We report on the incidence and features of esophageal eosinophilia diagnosed at our center in 2011 and compare the findings with previously published results between 1980-1988 and 2000-2002. Eosinophils per high-power field were counted in esophageal biopsies from 675 patients who underwent 710 endoscopic procedures between January 1, 2011, and December 31, 2011. Of these, 209 (33%) patients were infiltrated with eosinophils; the other 466 (67%) showed no pathological changes. The highest concentrations of eosinophils were observed in the distal esophagus. Our findings also indicate that esophageal eosinophilia fluctuates over time.
Assuntos
Eosinofilia/epidemiologia , Esofagite Eosinofílica/patologia , Eosinófilos/patologia , Esôfago/patologia , Adolescente , Biópsia , Criança , Pré-Escolar , Esofagite Eosinofílica/diagnóstico , Esofagite Eosinofílica/epidemiologia , Esofagoscopia , Feminino , Humanos , Lactente , Recém-Nascido , Contagem de Leucócitos , Masculino , Adulto JovemAssuntos
Doenças Autoimunes/diagnóstico , Doenças Autoimunes/tratamento farmacológico , Doenças Autoimunes/fisiopatologia , Colecistite/diagnóstico , Colecistite/tratamento farmacológico , Colecistite/fisiopatologia , Adolescente , Corticosteroides/uso terapêutico , Colangiopancreatografia Retrógrada Endoscópica/métodos , Colecistectomia/métodos , Dor Crônica/diagnóstico , Dor Crônica/tratamento farmacológico , Dor Crônica/fisiopatologia , Humanos , Imunoglobulina G/sangue , Icterícia/diagnóstico , Icterícia/tratamento farmacológico , Icterícia/fisiopatologia , Fígado/citologia , Fígado/patologia , Masculino , Mercaptopurina/uso terapêuticoRESUMO
Celiac disease is a gluten enteropathy that is treated with dietary elimination of gluten. Exposure to nondietary sources of gluten, which are used in the manufacture of products such as plastics, dental equipment, and cosmetics, can also trigger or exacerbate disease. We report the case of a 9-year-old child who presented with nonspecific abdominal discomfort with abnormal serology for celiac disease. She underwent duodenal biopsies that revealed Marsh 3B histopathology. Despite strict dietary elimination of gluten, she continued to be symptomatic and demonstrate positive serum markers for active disease. It was then discovered that the child was exposed to gluten from her orthodontic retainer that contained a plasticized methacrylate polymer. Gluten is a common additive in plastics. She discontinued its use and demonstrated symptom resolution and complete normalization of serology. All possible sources of gluten, including nondietary, must be considered when managing a child with celiac disease.
Assuntos
Doença Celíaca/dietoterapia , Glutens/administração & dosagem , Contenções Ortodônticas/efeitos adversos , Ácidos Polimetacrílicos/química , Doença Celíaca/classificação , Doença Celíaca/etiologia , Doença Celíaca/patologia , Criança , Dieta Livre de Glúten , Desenho de Equipamento , Feminino , Humanos , Intestino Delgado/patologia , Teste de Materiais , Plastificantes , Ácidos Polimetacrílicos/efeitos adversos , Indução de RemissãoRESUMO
We report a child who developed agitation and choreoathetoid movements with azithromycin therapy on 2 separate occasions. In both instances, the symptoms resolved when the antibiotic was discontinued. By means of the Naranjo adverse drug reaction probability scale, we classified this event as a probable adverse drug reaction (score of 6 points). To our knowledge, this is the first published case of azithromycin-induced agitation with choreoathetosis. Because this is a widely used medication for many common infectious conditions, including otitis media and pneumonia, this potential serious adverse reaction should be considered.