ABSTRACT
We describe the case of a 33 year-old woman who was hospitalized for ascites, abdominal pain and food allergy. Blood samples and histologic examination of a jejunal specimen removed by laparotomy revealed that the patient suffered from eosinophilic gastroenteritis. This disease is classified among the hypereosinophilic syndromes, and food allergy may be of etiologic importance. Clinically eosinophilic gastroenteritis may present with ascites, malabsorption or gut obstruction. The eosinophilic blood cell count is usually elevated and the erythrocyte sedimentation rate is usually normal or slightly increased. Polyarteritis nodosa, Crohn's disease and nematodal infections of the gut must be excluded. Most patients respond well to corticosteroid therapy and the long-term prognosis is good, even though the disease is chronic in nature.
Subject(s)
Eosinophilia/blood , Gastroenteritis/blood , Adult , Diagnosis, Differential , Eosinophilia/diagnosis , Eosinophilia/drug therapy , Female , Gastroenteritis/diagnosis , Gastroenteritis/drug therapy , HumansSubject(s)
Aneurysm/etiology , Cardiac Tamponade/mortality , Lymphatic Diseases/complications , Mucocutaneous Lymph Node Syndrome/complications , Polyarteritis Nodosa/complications , Cardiac Tamponade/etiology , Coronary Disease/complications , Coronary Disease/pathology , Coronary Vessels , Humans , Infant , Male , Myocardium/pathology , Rupture, SpontaneousABSTRACT
In the present material of 448 consecutive renal transplants the incidence of allograft rupture was 3.6%. Among 389 first transplants there were two ruptures in the living donor group (126 patients, 1.5%) and 12 ruptures in the cadaveric donor group (263 patients, 4.6%). Only one ruptured kidney (living donor) achieved long term function. Four patients with first graft rupture were retransplanted with early loss of the kidney in all, in two because of rupture. Two of these patients received a 3rd cadaveric graft, of which one is functioning well after two years. All ruptures occurred within three weeks after transplantation, 14 kidneys ruptured during the first week. The clinical course and the operative findings suggested that rejection was the cause of rupture in all cases. This was confirmed by light and immunofluorescent microscopy of specimens from 15 kidneys, while one kidney only demonstrated extensive intrarenal vessel thrombosis. It is concluded that renal allograft rupture signals a strong immunological response in the recipient with poor graft prognosis. The chance of a successful retransplantation is small.
