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1.
Arch. argent. pediatr ; 120(2): e80-e84, abril 2022. ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1363973

ABSTRACT

El síndrome de erupción medicamentosa con eosinofilia y síntomas sistémicos (drug reaction with eosinophilia and systemic symptoms, DRESS), también conocido como síndrome de hipersensibilidad inducida por medicamentos, es una reacción rara potencialmente mortal que causa una erupción grave y que puede provocar insuficiencia multiorgánica. Como con otras erupciones medicamentosas graves, los linfocitos T específicos para un medicamento tienen una función crucial en el síndrome DRESS. El modelo de hapteno/pro-hapteno, el modelo de interacción farmacológica y el modelo alterado de repertorio de péptidos son tres modelos diferentes desarrollados para describir la relación/interacción entre un medicamento o sus metabolitos y el sistema inmunitario. Analizamos nuestra experiencia con el tratamiento con ciclosporina en un caso de síndrome DRESS resistente a esteroides causado por ácido valproico en una niña y sus resultados clínicos, de laboratorio y de antígeno leucocitario humano (HLA).


Drug reaction with eosinophilia and systemic symptoms (DRESS), also known as drug-induced hypersensitivity syndrome, is a potentially life-threatening rare reaction that causes a severe rash and can lead to multiorgan failure. As in other severe drug eruptions, drug-specific T lymphocytes play a crucial role in DRESS. The hapten/pro-hapten model, pharmacological interaction model, and altered peptide repertoire model are three different models developed to describe the relationship/interaction between a medication or its metabolites and the immune system. We discuss our experience with cyclosporine treatment in a steroid-resistant DRESS syndrome caused by valproic acid in a girl, as well as her clinical, laboratory, and human leukocyte antigens (HLA) study results


Subject(s)
Humans , Female , Adolescent , Eosinophilia/complications , Eosinophilia/chemically induced , Drug Hypersensitivity Syndrome/diagnosis , Drug Hypersensitivity Syndrome/etiology , Valproic Acid/adverse effects , Cyclosporine , Haptens/adverse effects , HLA Antigens/adverse effects
2.
Article in English | LILACS | ID: biblio-1353510

ABSTRACT

ABSTRACT: Drug reactions with eosinophilia and systemic symptoms (DRESS) are rare and potentially fatal adverse hypersen-sitivity reaction to some drugs, especially anticonvulsants.The syndrome affects not only the skin but also other organs, especially the liver. The incidence can vary from 1 to 5 cases per 10.000 patients exposed to anticonvul-sants. The recognition of the syndrome is of fundamental importance since the mortality rate is between 10 and 40%. Once the diagnosis is established, the triggering drug must be identified and discontinued. Corticosteroids are usually associated with therapy. Autoimmune sequelae have been reported, including vitiligo and rarely alopecia. Alopecia universalis is a variant of alopecia areata, characterized by hair loss throughout the body. We report a case of DRESS, associated with two autoimmune dermatological diseases: alopecia universalis and vitiligo. (AU)


RESUMO: A reação a drogas com eosinofilia e sintomas sistêmicos (DRESS) é uma rara e potencialmente fatal reação adversa de hipersensibilidade, decorrente de alguns medicamentos, principalmente os anticonvulsivantes. A síndrome não afeta apenas a pele, mas também outros órgãos, principalmente o fígado. A incidência pode variar de 1 a 5 casos por 10.000 pacientes expostos aos anticonvulsivantes. O reconhecimento da síndrome é de fundamental importân-cia devido a taxa de mortalidade entre 10-40%. Uma vez estabelecido o diagnóstico, deve-se identificar o medica-mento desencadeante e suspendê-lo. O corticosteróide geralmente é associado na terapia. Sequelas autoimunes foram relatadas, incluindo vitiligo e raramente alopecia. A alopecia universal é uma variante da alopecia areata, caracterizada pela perda de pelos em todo o corpo. Relatamos um caso de DRESS, associado a duas doenças au-toimunes dermatológicas: alopecia universal e vitiligo. (AU)


Subject(s)
Humans , Male , Adult , Vitiligo , Drug Eruptions , Drug Hypersensitivity , Eosinophilia , Drug Hypersensitivity Syndrome , Anticonvulsants
3.
Rev. med. Risaralda ; 27(1): 96-100, ene.-jun. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1280499

ABSTRACT

Resumen El síndrome de DRESS (Reacción a drogas con eosinofilia y síntomas sistémicos) es una patología poco frecuente en Pediatría, descrita por primera vez en 1996, por Bocquet. Puede presentarse en un tiempo variable luego de exposición a algunos medicamentos, se caracteriza por fiebre, compromiso cutáneo y de órganos internos. En este caso, se presenta a un paciente de 13 años, con antecedente de uso de Trimetroprim sulfa desde hace 2 meses, con cuadro de 3 días consistente en fiebre y rash cutáneo, sin compromiso de mucosas, con respuesta no favorable al manejo con esteroide, requiriendo Inmunoglobulina IV. Semanas después del inicio de los síntomas y evolución estable presenta insuficiencia renal aguda que requirió terapia de reemplazo renal. Se descartaron otras patologías subyacentes de índole autoinmune. Hubo recuperación de azoados y normalización de los demás paraclínicos el día 40 de la enfermedad. El paciente continúa asintomático, 4 meses después, con tratamiento con esteroide oral, en descenso lento y gradual. Se debe considerar la evaluación permanente de las pruebas de función renal en los pacientes que presenten Síndrome de DRESS, por su asociación con Nefritis intersticial aguda y complicaciones relacionadas.


Abstract DRESS syndrome (Drug Reaction with Eosinophilia and Systemic Symptoms) is a rare pathology in Pediatrics, first described in 1996 by Bocquet. It can appear in a variable period of time after exposure to some medications, it is characterized by fever, skin involvement and internal organs. A 13-year-old patient is presented, with a history of use of Trimethoprim sulfa for two months, with a disease of three days of evolution, consisting of fever and skin rash, without mucosal involvement, with an unfavorable response to steroid management, requiring Intravenous inmunoglobulin. Weeks after the onset of symptoms and stable evolution, he presented acute renal failure that required renal replacement therapy. Other underlying autoimmune pathologies were ruled out. There was recovery of renal function test and normalization of the other paraclinical on day 40 of the disease. Patient remains asymptomatic four months later, with oral steroid treatment, in slow and gradual decline. Permanent evaluation of renal function tests should be considered in patients with DRESS syndrome, due to its association with acute tubulointerstitial nephritis and related complications.


Subject(s)
Humans , Male , Adolescent , Eosinophilia , Renal Insufficiency , Drug Hypersensitivity Syndrome , Kidney Function Tests , Nephritis, Interstitial , Steroids , Trimethoprim , Immunoglobulins , Pharmaceutical Preparations , Renal Replacement Therapy , Exanthema , Fever
4.
Arch. argent. pediatr ; 119(3): e247-e251, Junio 2021. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1248216

ABSTRACT

La reacción a drogas con eosinofilia y síntomas sistémicos es una reacción adversa cutánea rara, potencialmente grave. Puede presentar fiebre, erupción cutánea polimorfa, edema facial y/o linfoadenopatías. La reactivación del virus herpes humano tipo 6 se asocia a un curso más grave y/o prolongado.Un lactante de 22 meses en tratamiento con fenobarbital presentó lesiones eritematopapulares, fiebre, leucocitosis, proteína C reactiva elevada y alteración de pruebas hepáticas. Se realizó biopsia de piel compatible con reacción adversa a drogas. Se trató con corticoides sistémicos e inmunoglobulina intravenosa sin respuesta. La reacción en cadena de la polimerasa para virus herpes humano tipo 6 resultó positiva. Se inició ciclosporina más prednisona, con buena respuesta. Existe poca evidencia del uso de ciclosporina en adultos, cuando los corticoides sistémicos son inefectivos. Este es el primer reporte pediátrico Podría ser una alternativa efectiva o un complemento de los corticosteroides sistémicos cuando no responde a tratamientos convencionales.


Drug reaction with eosinophilia and systemic symptoms is a rare and potentially serious skin adverse reaction, with fever, polymorphous skin rash, facial edema, and/or lymphadenopathy. Reactivation of human herpes virus type 6 has been associated with a more severe and/or prolonged course. A 22-month-old infant under phenobarbital treatment developed erythematous-papular lesions, fever, leukocytosis, elevated C-reactive protein, and abnormal liver tests. The skin biopsy was compatible with an adverse drug reaction. Treatment with systemic corticosteroids and intravenous immunoglobulin had no response. Polymerase chain reaction for human herpesvirus type 6 was positive, and cyclosporine plus prednisone was started with a good response. There is little evidence for the use of cyclosporine in adults when systemic corticosteroids are ineffective. This is the first report of pediatric drug reaction with eosinophilia and systemic symptoms treated with cyclosporine, which could be an effective alternative or an adjunct to systemic corticosteroid therapy unresponsive to conventional treatments.


Subject(s)
Humans , Male , Infant , Herpesvirus 6, Human , Drug Hypersensitivity Syndrome/diagnosis , Cyclosporine/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Drug-Related Side Effects and Adverse Reactions , Eosinophilia , Drug Hypersensitivity Syndrome/complications , Drug Hypersensitivity Syndrome/therapy
5.
Arch. argent. pediatr ; 119(3): e234-e238, Junio 2021. tab, ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1248142

ABSTRACT

El síndrome de sensibilidad a fármacos con eosinofilia y síntomas sistémicos o síndrome de DRESS según sus siglas en inglés (drug reaction with eosinophilia and systemic symptoms) se encuentra entre las reacciones medicamentosas cutáneas graves. Este consiste en una tríada clínica que incluye fiebre, exantema y compromiso sistémico, acompañado de eosinofilia y/o linfocitos atípicos.Se presenta el caso de una paciente de sexo femenino con fibrosis quística, de 18 meses de edad, quien desarrolló esta patología durante un tratamiento con trimetoprima-sulfametoxazol para erradicar Staphylococcus aureus meticilino resistente en esputo. Los pacientes con fibrosis quística reciben múltiples esquemas antibióticos según bacteriología en secreciones respiratorias para evitar el deterioro de la función pulmonar y colonización por gérmenes resistentes. Es menester conocer y sospechar este síndrome, debido al riesgo incrementado de hipersensibilidad a drogas en fibrosis quística, pronóstico ominoso y su elevada morbimortalidad


Drug reaction with eosinophilia and systemic symptoms or DRESS syndrome is among severe cutaneous drug reactions. This constitutes a clinical triad that includes fever, skin rash and systemic compromise, accompanied by eosinophilia and/or atypical lymphocytes.We present the case of an 18-month-old female patient with cystic fibrosis, who develops this pathology during a trimethoprim-sulfamethoxazole cycle as an eradicating treatment of methicillin-resistant Staphylococcus aureus in bronchial secretions. Cystic fibrosis patients receive multiple antibiotic regimens according to bacteriology in sputum, to avoid impairment in their lung function and colonization by resistant germs. Due to the increased risk of drug hypersensitivity in cystic fibrosis, an ominous prognosis and high morbidity and mortality, knowledge and a high index of suspicion of this syndrome are necessary


Subject(s)
Humans , Female , Infant , Cystic Fibrosis , Drug Hypersensitivity Syndrome/diagnosis , Staphylococcus aureus , Trimethoprim, Sulfamethoxazole Drug Combination/adverse effects , Drug-Related Side Effects and Adverse Reactions , Eosinophilia/diagnosis , Drug Hypersensitivity Syndrome/complications
6.
Rev. Hosp. Ital. B. Aires (2004) ; 41(1): 21-25, mar. 2021. ilus, tab
Article in Spanish | LILACS | ID: biblio-1178296

ABSTRACT

El síndrome DRESS es una reacción adversa dermatológica que puede presentarse debido a diversos medicamentos, y constituye uno de los diagnósticos más importantes por encima del síndrome de Stevens-Johnson. Se trata de un caso relacionado con una reacción adversa de muy baja frecuencia, que está documentada en la literatura científica, a varios medicamentos, entre ellos la fenitoína. Por lo mencionado, la publicación de estos casos resulta escasa y limitada. Las principales preocupaciones del paciente relacionadas con su cuadro clínico radicaban en el gran compromiso cutáneo que lo llevó a hospitalización, dolor e incomodidad, por el cual recurrió al manejo tópico generalizado con vaselina. Los hallazgos clínicos relevantes fueron: eosinofilia severa, ulceraciones cutáneas, hepatitis química y fiebre. Con los hallazgos del cuadro clínico y la evaluación de la escala RegiSCAR se hace el diagnóstico de síndrome DRESS inducido por fenitoína. Se suspende la fenitoína, se inicia levetiracetam y se administran corticosteroides y acetaminofén con evolución favorable. (AU)


DRESS syndrome is a dermatological adverse reaction can occur due to various medications, being one of the most important diagnoses above Steven-Johnson syndrome. This is a case related to a very low frequency adverse reaction that is documented in the scientific literature to several medicines among those, the phenytoin. Therefore, the publication of these cases is scarce and limited. The main concerns of the patients related to their clinical picture were due to the great cutaneous compromise that lead to hospitalization, pain and discomfort for which they resorted to generalized topical management with vaseline (petrolatum). Relevant clinical findings were severe eosinophilia, skin ulcerations, chemical hepatitis and fever. With clinical picture findings and evaluation of the RegiSCAR scale, the diagnosis of Phenytoin-induced DRESS syndrome is made. Phenytoin is discontinued, levetiracetam is started and corticosteroids and acetaminophen are administrated with favorable evolution. (AU)


Subject(s)
Humans , Male , Middle Aged , Phenytoin/adverse effects , Drug Hypersensitivity Syndrome/diagnosis , Petrolatum/therapeutic use , Phenytoin/administration & dosage , Albendazole/administration & dosage , Adrenal Cortex Hormones/administration & dosage , Eosinophilia/etiology , Exanthema/diagnosis , Levetiracetam/administration & dosage , Acetaminophen/therapeutic use
8.
Article in English | WPRIM | ID: wpr-922406

ABSTRACT

A boy, aged 17 years, was admitted again due to abdominal pain, diarrhea, and eosinophilia for 3 years, which worsened for 3 days. Three years ago, the boy suffered from abdominal pain and diarrhea after eating yogurt; color Doppler ultrasound showed a large amount of peritoneal effusion, and routine blood test, bone marrow cell morphology, and ascites histological examination showed a large number of eosinophils. Three days ago, he was admitted again due to abdominal pain and diarrhea. The gastrointestinal endoscopy showed eosinophil infiltration in the angle of stomach. The boy was diagnosed with eosinophilic gastrointestinal disease (eosinophilic gastroenteritis). He was improved after the treatment with glucocorticoids and dietary avoidance, and no recurrence was observed during the one-year follow-up. It is concluded that for children who attend the hospital due to gastrointestinal symptoms such as abdominal pain and diarrhea, if there is an increase in peripheral blood eosinophils, it is necessary to consider the possibility of eosinophilic gastrointestinal disease, and eosinophil infiltration and abnormal eosinophil count in gastrointestinal tissue based on endoscopic biopsy may be the key to diagnosis.


Subject(s)
Abdominal Pain/etiology , Ascitic Fluid , Enteritis , Eosinophilia/etiology , Gastritis , Humans , Male
9.
Article in English | WPRIM | ID: wpr-922403

ABSTRACT

OBJECTIVES@#To study the predictive factors for glucocorticoid therapy by analyzing the association between the clinical features and treatment regimens in children with eosinophilic gastroenteritis.@*METHODS@#A retrospective analysis was performed on the medical data of 182 children with eosinophilic gastroenteritis who were admitted to Guangzhou Women and Children's Medical Center from January 2012 to December 2020. According to whether glucocorticoids were used, these children were divided into a glucocorticoid treatment group and a control group. The two groups were compared in terms of age, history of allergy, clinical symptoms, laboratory examination results, endoscopic findings, and pathological results of gastrointestinal mucosa. A multivariate logistic regression analysis was performed for the results with statistical significance.@*RESULTS@#Of the 182 children, 36 (19.8%) received glucocorticoid therapy. The rates of hematochezia, anemia, and mucosal ulceration/luminal stenosis under endoscopy and the mucosal eosinophil infiltration count were significantly higher in the glucocorticoid treatment group than those in the control group (@*CONCLUSIONS@#Mucosal ulceration/luminal stenosis under endoscopy or a significant increase in the mucosal eosinophil infiltration count based on pathology suggests that glucocorticoid therapy can be considered in children with eosinophil gastroenteritis.


Subject(s)
Child , Enteritis/drug therapy , Eosinophilia/drug therapy , Female , Gastritis , Glucocorticoids/therapeutic use , Humans , Retrospective Studies
10.
Braz. J. Vet. Res. Anim. Sci. (Online) ; 58: e175896, 2021. tab, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1348003

ABSTRACT

Systemic mastocytosis (SM) pathology is extremely rare in canine practice, with insufficient reported data. The knowledge of the clinical behavior of this pathology is scarce. In human medicine, SM has been widely investigated, being defined as a rare hematopoietic disorder by the World Health Organization (2016), within the type of myeloproliferative neoplasms. Herein, we describe a systemic mastocytosis case in a Portuguese Serra-da-Estrela dog, where a cutaneous grade III/high-grade MCT was also diagnosed. The clinical decline of the animal and owner's insistence throughout anamnesis that the dog was markedly different after the cytologic exam performed in another clinic, along with both severe eosinophilia and hepatomegaly, led to the clinical suspicion of SM. The animal passed away 7 days later. Post-morteminvestigation confirmed SM pathology, and a deletion of 15 base pairs change on c-Kit gene exon 11 was identified. Contemplating the low number of cases described in the literature, this publication aims to disclose clinical and laboratory features of rare and poorly described canine SM, taking into consideration human outcomes described in the literature.(AU)


A patologia da mastocitose sistêmica (SM) é extremamente rara na prática clínica canina, com escassos casos descritos na literatura científica. O conhecimento do comportamento clínico desta patologia é mínimo. Na medicina humana, a SM tem sido amplamente investigada, sendo definida como uma doença hematopoiética rara pela Organização Mundial da Saúde (2016), dentro do tipo de neoplasias mieloproliferativas. Descrevemos aqui um caso de mastocitose sistêmica num cão Serra-da-Estrela português, diagnosticado também com um mastocitoma cutâneo grau III / alto grau. O declínio clínico do animal e a insistência do proprietário durante a anamnese de que o cão estava marcadamente diferente após o exame citológico realizado em outra clínica, juntamente com eosinofilia e hepatomegalia graves, levantaram a suspeita clínica de SM. O animal faleceu 7 dias depois. A investigação post-mortem confirmou a patologia SM, e o estudo molecular revelou uma deleção de 15 pares de bases no exon 11 do gene c-Kit. Contemplando o baixo número de casos descritos na literatura, o objetivo desta publicação é divulgar características clínicas e laboratoriais de SM canina, levando em consideração informações clínicas descritas em humanos.(AU)


Subject(s)
Animals , Mastocytosis, Systemic/pathology , Eosinophilia/veterinary , Proto-Oncogene Proteins c-kit , Hepatomegaly
11.
Article in English | LILACS, VETINDEX | ID: biblio-1347991

ABSTRACT

Eosinophilic cystitis is a rare inflammatory disorder characterized by eosinophilic infiltration of entire layers of the bladder wall. The condition has been described in adults, children, and dogs. However, there are no consensus guidelines for the treatment of eosinophilic cystitis. Although human and veterinary literature reviews show some effectiveness in management with corticosteroids, antihistamines, and antibiotics, a variety of serious and frequent side effects are associated with steroid therapy. As a result, steroids are relatively contraindicated for patients with diabetes mellitus and Cushing's syndrome. A five-year-old neutered male chow-chow with controlled diabetes was referred with an 18-month history of malodorous urine, gross haematuria, and dysuria that were nonresponsive to antibiotics. The findings on general examination were unremarkable except for abdominal suprapubic discomfort. The complete blood count and biochemical profile (such as urea and creatinine) were normal except for mild peripheral eosinophilia. Although ultrasonography, bladder contrast radiography, and urine cytology findings indicated malignancy, with the presence of atypical urothelial cells, histopathology confirmed eosinophilic cystitis. Management with cyclosporine was adequate with complete remission of haematuria. This case report presents the first reported successful use of cyclosporine for the treatment of eosinophilic cystitis in a dog with diabetes.(AU)


A cistite eosinofílica é uma doença inflamatória rara caracterizada por infiltração eosinofílica de todas as camadas da parede da bexiga. Essa enfermidade já foi descrita em adultos, crianças e cães. No entanto, não há um consenso de diretrizes sobre o seu tratamento. Mesmo que as literaturas humana e veterinária mostrem alguma eficácia no manejo com corticosteroides, anti-histamínicos e antibióticos, uma variedade de efeitos colaterais graves e frequentes está associada à terapia com esteroides. Dessa forma, o uso de esteroides é relativamente contraindicado para pacientes com diabetes mellitus e síndrome de Cushing, por exemplo. Um chow-chow, macho, castrado, de cinco anos e diabético estável foi encaminhado para atendimento com histórico de urina fétida, hematúria macroscópica e disúria não responsiva a antibióticos há 18 meses. A avaliação dos parâmetros físicos estava dentro dos padrões, exceto por desconforto abdominal suprapúbico à palpação. O hemograma e o perfil bioquímico (como a ureia e a creatinina) estavam dentro da normalidade para a espécie, exceto por eosinofilia periférica leve. Embora a ultrassonografia, a radiografia contrastada da bexiga e os achados da urinálise indicassem malignidade, com a presença de células uroteliais atípicas, a histopatologia confirmou o diagnóstico definitivo de cistite eosinofílica. O manejo com ciclosporina foi satisfatório, com ausência completa da hematúria. Este relato de caso apresenta o primeiro uso documentado de ciclosporina para o tratamento de cistite eosinofílica com sucesso em um cão com diabetes.(AU)


Subject(s)
Animals , Dogs , Cyclosporine , Cystitis , Dogs , Hematuria , Enterobacter , Eosinophilia , Klebsiella pneumoniae
12.
Braz. j. med. biol. res ; 54(6): e10745, 2021. graf
Article in English | LILACS | ID: biblio-1285666

ABSTRACT

Episodic angioedema with eosinophilia (EAE) is a rare condition characterized by recurrent attacks of angioedema and urticaria accompanied by a marked elevation of peripheral eosinophil count. We report the case of a young female patient diagnosed with EAE associated with urticarial vasculitis. A 40-year-old female patient was admitted to our institution due to recurrent episodes of cheek and eyelid angioedema in the previous year. Episodes of facial angioedema lasted for two months with spontaneous remission afterwards. In addition, she presented pruritic and painful skin eruptions of erythematous circles, which persisted for longer than 24 h, that were palpable, somewhat purplish, and more pronounced on the face, arms, and trunk. Laboratory investigation showed a sustained elevation of white cell counts with marked eosinophilia. Serum IgM, IgE, and IgA were normal; IgG was slightly elevated. C1-esterase inhibitor and tryptase test were normal. Reverse transcriptase-polymerase chain reaction was performed for detection of FIP1L1-PDGFRA and BCR-ABL rearrangements. None of these alterations were found. Skin biopsies were suggestive of urticarial vasculitis. The patient was submitted to esophagogastroduodenoscopy, which showed mild chronic gastritis, with no eosinophilic infiltration. Cardiac dimensions and function were normal. Abdominal ultrasound and total body CT-scan failed to show lymphadenopathy, organomegaly, and tumors. We report the first case of association between episodic angioedema with eosinophilia and urticarial vasculitis. It is possible that both conditions share a physiopathological mechanism, suggesting that it is not just a chance association.


Subject(s)
Humans , Female , Adult , Urticaria/complications , Vasculitis , Eosinophilia/complications , Angioedema/complications , Angioedema/diagnosis , Skin
13.
Neumol. pediátr. (En línea) ; 16(2): 62-68, 2021. ilus, tab
Article in Spanish | LILACS | ID: biblio-1293286

ABSTRACT

El asma es la enfermedad respiratoria crónica pediátrica más frecuente. En la mayoría de los niños se caracteriza por inflamación de la vía aérea de tipo eosinofílica alérgica. La fracción espirada de óxido nítrico (FENO) es un biomarcador de inflamación eosinofílica de vía aérea, su medición es no invasiva y fácil de realizar y ha sido evaluado en los últimos años para su aplicación clínica en el diagnóstico y tratamiento del asma en niños y adultos. Esta revisión abordará el origen anatómico y bioquímico del FENO, aspectos prácticos de su medición, valores de referencia y su aplicación clínica en el diagnóstico y tratamiento del asma pediátrico.


Asthma is the most common pediatric chronic disease characterized in most children by allergic eosinophilic airway inflammation. The exhaled fraction of nitric oxide (FENO) is a biomarker of eosinophilic airway inflammation, constituting a non-invasive and easy-to-perform test that has been evaluated in recent years for its clinical application in the diagnosis and treatment of asthma in children and adults. This review will address the anatomical and biochemical origin of FENO, practical aspects of its measurement, reference values and its clinical application in the diagnosis and treatment of pediatric asthma.


Subject(s)
Humans , Asthma/diagnosis , Nitric Oxide/analysis , Asthma/metabolism , Breath Tests , Biomarkers , Exhalation , Eosinophilia , Inflammation , Nitric Oxide/metabolism
14.
Rev. cuba. anestesiol. reanim ; 19(3): e639, sept.-dic. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1138883

ABSTRACT

Introducción: Actualmente se buscan biomarcadores que se modifiquen paralelamente con la historia natural de la sepsis. Objetivo: Describir las variaciones de la proteína C reactiva, la eritrosedimentación y el conteo de eosinófilos en pacientes graves portadores de enfermedad infecciosa en diferentes etapas. Método: Se realizó una investigación aplicada y analítica de cohorte, según el estado de la temática, alcance y aplicabilidad de los resultados. Se realizó en pacientes graves con enfermedades infecciosas ingresados en la unidad cuidados intensivos del Hospital Saturnino Lora, durante marzo de 2018 hasta marzo de 2019. El universo estuvo constituido luego de aplicar los criterios de inclusión y exclusión por 41 pacientes, 21 fallecidos y 20 vivos. Las variables estudiadas fueron edad, sexo, origen, gravedad y seguimiento del proceso infeccioso, biomarcadores de respuesta inflamatoria e infección y estado al egreso. Para el procesamiento de la información estadística se emplearon valores promedios como medidas de resumen para variables cuantitativas y porcentajes para variables cualitativas. Para la asociación estadísticamente significativa entre los criterios de interés se aplicó el Test X2 de Independencia. Resultados: La sepsis resultó más frecuente en pacientes masculinos en edades intermedias de la vida, fundamentalmente de origen respiratorio y fue la eosinopenia el biomarcador que más se alteró en los diferentes momentos de la investigación Conclusión: El biomarcador asociado a la sepsis que más se alteró en los diferentes momentos del estudio fue la eosinopenia con mayor asociación como predictor de mortalidad en los diferentes momentos que se realizó el análisis(AU)


Introduction: Currently, biomarkers are being sought that become modified in parallel with the natural history of sepsis. Objective: To describe the variations in C-reactive protein, erythrocyte sedimentation and eosinophil count in severely-ill patients with infectious disease at different stages. Method: An applied and analytical cohort research was carried out, according to the state of the subject, scope and applicability of the outcomes. It was carried out in severely-ill patients with infectious diseases admitted to the intensive care unit of the Saturnino Lora Hospital, from March 2018 to March 2019. The study population was made up after applying the inclusion and exclusion criteria in 41 patients, 21 deceased and 20 alive. The variables studied were age, sex, origin, severity, and monitoring of the infectious process, biomarkers of inflammatory response and infection, and discharge status. For the processing of statistical information, mean values TX 2;were used as summary measures for quantitative variables and percentages for qualitative variables. For the statistically significant association between the criteria of interest, the chi-square Independence test was applied. Results: Sepsis was more frequent among male patients in intermediate ages of life, mainly of respiratory origin; while eosinopenia was the biomarker that was most altered at different moments of the investigation Conclusion: The biomarker associated with sepsis that was most altered at different times of the study was eosinopenia, with the greatest association as a predictor for mortality at the different times when the analysis was performed(AU)


Subject(s)
Humans , Middle Aged , Aged, 80 and over , Biomarkers/analysis , Sepsis/diagnosis , Sepsis/epidemiology , Eosinophilia/complications , Intensive Care Units , Epidemiology, Descriptive , Cohort Studies
15.
Rev. am. med. respir ; 20(3): 279-281, sept. 2020. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1123111

ABSTRACT

Las eosinofilias pulmonares constituyen un grupo variado de entidades cuyo nexo común es la inflamación eosinofílica que puede o no asociarse a eosinofilia periférica. En ese reporte describimos una forma atípica y no descripta de presentación como "pseudotumor pulmonar" que remitió con tratamiento corticoesteroideo.


Pulmonary eosinophilia are a varied group of entities sharing the eosinophilic inflammation that may or may not be associated with peripheral eosinophilia. This report describes an atypical, undescribed presentation, the "pulmonary pseudotumor" which showed regression with corticosteroid treatment.


Subject(s)
Humans , Pulmonary Eosinophilia , Therapeutics , Plasma Cell Granuloma, Pulmonary , Eosinophilia
16.
Rev. medica electron ; 42(4): 2121-2129,
Article in Spanish | LILACS, CUMED | ID: biblio-1139302

ABSTRACT

RESUMEN La enteritis eosinofílica consiste en la presencia de infiltrados eosinofílicos en el tracto digestivo. Constituye en la actualidad una entidad rara que puede localizarse en cualquier región del tubo digestivo. Su etiopatogenia se desconoce y en muchas ocasiones se relaciona con antecedentes de atopia. Las manifestaciones clínicas varían en función de las capas afectadas. Se presentó el caso de un paciente de 26 años de edad, con antecedentes de haber sido operado de apendicitis aguda, en el año 2011. Llegó al Cuerpo de Guardia refiriendo dolor intenso, fijo; en fosa iliaca derecha, acompañado de fiebre de 39°C, con escalofríos y síntomas dispéptico. Se orientó ingreso y se le realizó una videoendoscopia, se observó gastritis antral eritematosa exudativa con test para Helicobacter pylori positivo. Además, una videolaparoscopia arrojando presencia de asas delgadas apelotonadas y adherencias no recientes en fosa iliaca derecha. A pesar del tratamiento empleado el paciente continuó con dolor y fiebre, por lo que se decidió indicarle una enteroscopia de doble balón con biopsia de íleon. Se informó que a nivel del colon presentaba una colitis crónica inespecífica y en el íleon una hiperplasia linfoide. El estudio histopatológico confirmó la colitis inespecífica y una eosinofilia moderada en íleon. Se indicó tratamiento con prednisona y mesalazina con mejoría notable del cuadro clínico, fue dado de alta con el diagnóstico de una enteritis eosinofílica, con seguimiento por consulta externa de gastroenterología. En la actualidad se mantiene asintomático (AU).


ABSTRACT Eosinophilic enteritis is the presence of eosinophilic infiltrates in the digestive tract. Currently it is a rare entity than could be located in any region of the digestive tract. Its etiopathogenesis is unknown and is related, in many cases, to antecedents of atopy, Clinical manifestations may vary according to the affected layer. The authors present the case of a patient aged 26 years, with antecedents of having undergone an acute appendicitis surgery in 2011. He arrived to Emergency referring intense, steady pain in the right iliac fossa, accompanied by a 39o C fever, chills and dyspeptic symptoms. He was admitted and a video endoscopy was carried out. An exudative erythematous antral gastritis was observed with a positive test for Helicobacter pylori. In addition, video laparoscopy also showed the presence of thin, lumped loops and no-recent adherences in the right iliac fossa. In spite of the applied treatment, the patient continued with pain and fever, so the doctors indicated a double-balloon enteroscopy with ileum biopsy. It was informed an unspecific chronic colitis at the colon level and a lymphoid hyperplasia in the ileum. The histopathologic study confirmed the unspecific colitis and a moderate eosinophilia in the ileum. A prednisone and mesalazine treatment was indicated with a notable improvement of the clinical characteristics. The patient was discharged diagnosed with a eosinophilic enteritis and follow-up in out-patient consultation of Gastroenterology. Currently he keeps on asymptomatic (AU).


Subject(s)
Humans , Female , Young Adult , Enteritis/diagnosis , Eosinophilia/diagnosis , Signs and Symptoms , Therapeutics , Case Reports , Colitis/classification , Colitis/diagnosis , Gastroenterology
17.
Int. j. morphol ; 38(4): 882-887, Aug. 2020. tab, graf
Article in English | LILACS | ID: biblio-1124870

ABSTRACT

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.


Subject(s)
Humans , Male , Prostatic Neoplasms/pathology , Prostate/pathology , Prostatic Neoplasms/diagnosis , Biopsy , Mastocytosis/pathology , Biomarkers, Tumor/analysis , Chile , Age Factors , Eosinophilia/pathology , Early Detection of Cancer , Neoplasm Grading
18.
Rev. cuba. med. trop ; 72(1): e475, ene.-abr. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1126701

ABSTRACT

Introducción: El parásito Angiostrongylus cantonensis es el principal causante de meningitis eosinofílica. En el 2008 se reportó el primer caso en Ecuador y un estudio reciente en la Ciudad de Chone, Manabí, Ecuador determinó una alta prevalencia del parásito en el caracol africano (Achatina fulica). Objetivo: Identificar los factores de riesgo asociados a la meningitis eosinofílica causada por A. cantonensis en la ciudad de Chone. Métodos: Se entrevistaron a 500 personas residentes en la ciudad de Chone y se revisaron las historias clínicas del Hospital General de Chone. Resultados: Se observó que la población de Chone, está expuesta a los siguientes factores de riesgos: consumo de caracoles crudos (7,40 por ciento), el frecuente contacto de las personas con el caracol africano en la casa (67 por ciento), como en el trabajo (51,20 por ciento), el contacto que tienen los niños con caracoles, al jugar en el jardín (76,80 por ciento) y la incorrecta limpieza de los alimentos (54,40 por ciento). En el entorno de la población, se evidenció la presencia del caracol africano cerca de las casas en el 35,20 por ciento y las ratas, en el 50,80 por ciento. Además, el 34 por ciento de la muestra de estudio presentó sintomatología relacionada con meningitis eosinofílica. Se encontró que existía asociación entre la presencia de vectores cerca de las casas y la cantidad de síntomas manifestados por las personas. Conclusiones: Se evidenció que la población de Chone, manifiesta hábitos que exponen a la gente de esta localidad a un alto riesgo de contagio de meningitis eosinofílica(AU)


Introduction: The parasite Angiostrongylus cantonensis is the main causative agent of eosinophilic meningitis. The first case in Ecuador was reported in 2008, and a recent study conducted in the city of Chone, Manabí, Ecuador, determined a high prevalence of the parasite in the African snail (Achatina fulica). Objective: Identify the risk factors associated to eosinophilic meningitis caused by A. cantonensis in the city of Chone. Methods: Interviews were conducted with 500 residents from the city of Chone and a review was carried out of the medical records at Chone General Hospital. Results: It was found that the population of Chone is exposed to the following risk factors: eating raw snails (7.40 percent), frequent contact between people and African snails both at home (67 percent) and at work (51.20 percent), contact between children and snails while playing in gardens (76.80 percent) and washing food items incorrectly (54.40 percent). In the areas surrounding people's households the African snail was found in 35.20 percent and rats in 50.80 percent . Additionally, 34 percent of the study sample had symptoms of eosinophilic meningitis. An association was found between the presence of vectors near the houses and the number of symptoms occurring in people. Conclusions: It was evident that the population of Chone has habits which expose them to a high risk for eosinophilic meningitis(AU)


Subject(s)
Humans , Male , Female , Snails , Strongylida Infections/complications , Eosinophilia/chemically induced , Meninges/physiopathology
19.
Rev. Soc. Peru. Med. Interna ; 33(1): 25-30, ene.-mar. 2020. ilus, tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1116184

ABSTRACT

Varón de 77 años de edad, con antecedentes de insuficiencia cardiaca y fibrilación auricular recibiendo warfarina, hipotiroidismo, diabetes mellitus e hiperuricemia, con historia de un año de lesiones dérmicas eritematosas y descamativas en el tronco, pruriginosas y con moderada eosinofilia recurrente. Después de descartarse causas alérgicas, parasitarias, autoinmunes y neoplásicas, se hizo el diagnóstico de síndrome hipereosinofílico idiopático. Recibió tratamiento con prednisona e hidroxiurea, consiguiéndose una remisión completa de la eosinofilia y mejoría progresiva de las lesiones dérmicas. (AU)


A 77-year-old male, with a history of heart failure and atrial fibrillation receiving warfarin, hypothyroidism, diabetes mellitus and hyperuricaemia, with a one-year history of erythematous and desquamative skin lesions in the trunk, pruritic and moderate recurrent eosinophilia. After allergic, parasitic, autoimmune and neoplastic causes were ruled out, the diagnosis of idiopathic hypereosinophilic syndrome was done. He was treated with prednisone and hydroxyurea, resulting in complete remission of eosinophilia and progressive improvement of dermal lesions. (AU)


Subject(s)
Humans , Male , Aged , Skin , Prednisone , Hypereosinophilic Syndrome , Eosinophilia
20.
Rev. chil. neuro-psiquiatr ; 58(1): 61-65, mar. 2020. tab
Article in Spanish | LILACS | ID: biblio-1115471

ABSTRACT

Resumen Se han descrito una serie de reacciones adversas asociadas a antipsicóticos, entre las que destacan las reacciones adversas hematológicas propias de algunos antipsicóticos atípicos. Las más renombradas han sido clásicamente las discrasias sanguíneas asociadas al uso de olanzapina. En este trabajo nos enfocamos en una reacción adversa poco común: eosinofilia en un paciente esquizofrénico paranoide usuario de olanzapina, situación documentada en contadas publicaciones a lo largo de la historia de uso de este medicamento. Se trata de una reacción adversa infrecuente, y por lo mismo poco conocida y estudiada.


Many adverse effects of antipsychotic drugs have been described, among which hematologic adverse effects stand out. Classically, blood discrasias have been associated to the use of olanzapine. On this paper we will focus on an uncommon adverse reaction: eosinophilia in a patient diagnosed with a paranoid schitzophrenia, who had been using olanzapine. There have been just a few reported cases of eosinophilia secondary to the use of olanzapine, which makes this an infrequent, rarely known and even less studied adverse reaction.


Subject(s)
Humans , Male , Adult , Schizophrenia , Antipsychotic Agents , Eosinophilia , Olanzapine
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