ABSTRACT
OBJECTIVES: Hypereosinophilic syndromes (HSS) are a rare group of heterogeneous disorders characterized by prominent and persistent eosinophilia and organ dysfunction. Secondary causes of eosinophilia must be excluded. Recent advances in molecular biology and cytogenetics have permitted the characterization of different subsets of hypereosinophilic syndrome. We describe a patient with the lymphocytic variant. PATIENT: A 46-year old male Philippine patient presented skin lesions, fever, red eyes, enlarged lymph nodes and marked eosinophilia. RESULTS: Lymphocytic phenotyping by flow cytometry analysis was performed on peripheral blood and an aberrant population of T lymphocytes CD3-CD4+ producing interleukin 5 was found. TCR gene rearrangement using PCR amplification confirmed T cell clonality. CONCLUSIONS: The lymphocytic variant of the hypereosinophilic syndrome is a primitive lymphocytic disorder characterized by a non-malignant T cell population expansion producing eosinophilopoietic cytokines, with an indolent clinical course but that can transform into a peripheral T lymphoma. We report the first case of such a variant published in our country and review the characteristics of this variety.
Subject(s)
Hypereosinophilic Syndrome/classification , Angiolymphoid Hyperplasia with Eosinophilia/pathology , Humans , Hypereosinophilic Syndrome/pathology , Male , Middle AgedABSTRACT
Fundamento: El síndrome hipereosinófilo (SHE) es un grupo heterogéneo de procesos raros caracterizados por un aumento prominente y sostenido de eosinófilos en sangre y daño orgánico. Se deben excluir otras causas de hipereosinofilia. Avances recientes en biología molecular y citogenética han permitido caracterizar diferentes subtipos. Se describe un caso de la variedad linfoide. Paciente: Varón filipino de 46 años que consulta por lesiones cutáneas, fiebre, conjuntivitis, adenopatías y eosinofilia prominente. Resultados: El estudio de poblaciones linfocitarias en sangre periférica revela una población aberrante de linfocitos T (LT) CD3-CD4+ productora de interleucina 5 (IL-5). Se confirmó la clonalidad del TCR mediante PCR. Conclusiones: La variedad linfoide del SHE está caracterizada por una expansión clonal de LT no maligna que produce IL-5, de comportamiento indolente, pero que puede evolucionar a linfoma T periférico. Se describe el primer caso de variedad linfoide publicada en nuestro país y se revisan las características de esta variedad (AU)
Objectives: Hypereosinophilic syndromes (HSS) are a rare group of heterogeneous disorders characterized by prominent and persistent eosinophilia and organ dysfunction. Secondary causes of eosinophilia must be excluded. Recent advances in molecular biology and cytogenetics have permitted the characterization of different subsets of hypereosinophilic syndrome. We describe a patient with the lymphocytic variant. Patient: A 46-year old male Philippine patient presented skin lesions, fever, red eyes, enlarged lymph nodes and marked eosinophilia. Results: Lymphocytic phenotyping by flow cytometry analysis was performed on peripheral blood and an aberrant population of T lymphocytes CD3-CD4+ producing interleukin 5 was found. TCR gene rearrangement using PCR amplification confirmed T cell clonality. Conclusions: The lymphocytic variant of the hypereosinophilic syndrome is a primitive lymphocytic disorder characterized by a non-malignant T cell population expansion producing eosinophilopoietic cytokines, with an indolent clinical course but that can transform into a peripheral T lymphoma. We report the first case of such a variant published in our country and review the characteristics of this variety (AU)
Subject(s)
Humans , Male , Middle Aged , Hypereosinophilic Syndrome/classification , Eosinophilia/classification , Angiolymphoid Hyperplasia with Eosinophilia/physiopathology , Angiolymphoid Hyperplasia with Eosinophilia/pathology , Hypereosinophilic Syndrome/pathology , Eosinophilia/pathology , Signs and SymptomsSubject(s)
Brucellosis/diagnosis , Heparin , Rose Bengal , Drug Interactions , False Positive Reactions , HumansABSTRACT
UNLABELLED: We analyze retrospectively 132 cases of brucellosis evaluating the performance of diagnostic procedures, complications and serological and clinical evolution. We compare the 74 patients treated with streptomycin plus tetracycline versus the 41 patients treated with doxycycline plus rifampicin. The more outstanding results we find: a) Great sensibility of the rose bengal test; b) Higher relapse rate in the more severe cases (p less than 0.01); c) Good evolution with scarce relapse rate in both treatment groups; agglutination titers were lower at one year in the group treated with doxycycline plus rifampicin (p less than 0.05). CONCLUSIONS: Both treatments showed good efficacy, controlled studies would be needed to determine the most adequate one.
Subject(s)
Brucellosis/diagnosis , Rural Population , Age Factors , Antibodies, Bacterial/blood , Brucella/immunology , Brucellosis/complications , Brucellosis/epidemiology , Humans , Recurrence , Retrospective Studies , Rural Population/statistics & numerical data , Seroepidemiologic Studies , Sex Factors , Spain/epidemiologyABSTRACT
We report a case of a 48-year-old woman who had a 4 years history of bilateral blepharospasm. CT-scan showed multiple intracranial calcifications (two of them in the left thalamus) corresponding to neurocysticerosis, and a lacunar infarction in right internal capsule area. To our knowledge this case is the first one reported in the literature of blepharospasm associated with (and perhaps symptomatic of?) neurocysticercosis.
Subject(s)
Blepharospasm/etiology , Brain Diseases/parasitology , Calcinosis/parasitology , Cysticercosis/complications , Brain Diseases/complications , Brain Diseases/diagnosis , Calcinosis/complications , Calcinosis/diagnosis , Cysticercosis/diagnosis , Female , Humans , Middle AgedABSTRACT
We report the case of a woman suffering from complex partial seizures who developed Parkinson's disease at the age of 58. Parkinsonian symptoms improved transitorily after complex partial seizures. Although this has been reported after generalized seizures, this case is, to our knowledge, the first description of improvement of parkinsonian symptoms following a complex partial seizure.
Subject(s)
Epilepsies, Partial/complications , Parkinson Disease/complications , Female , Humans , Middle AgedABSTRACT
Central nervous system involvement in systemic brucellosis is not frequent. Neurobrucellosis may involve several areas of the central nervous system and may be the cause of several clinical pictures. We report a case of brucellar meningitis that was clinically indistinguishable from a migrainous syndrome. The diagnosis of brucellar meningitis was confirmed by the isolation of Brucella sp. in the cerebrospinal fluid.
Subject(s)
Brucellosis/diagnosis , Meningitis/diagnosis , Migraine Disorders/diagnosis , Adolescent , Anti-Bacterial Agents/therapeutic use , Brucella/isolation & purification , Brucellosis/cerebrospinal fluid , Brucellosis/drug therapy , Diagnosis, Differential , Female , HumansABSTRACT
A prospective study of 3 years' duration on the etiology of late onset epilepsy was carried out in a rural health area with a population of 135,000. Eighty patients were included. History, neurological physical examination, electroencephalogram, cranial computed tomographic scan (CT) and general laboratory investigations were carried out. The cause of epilepsy was unknown in 51.3% of cases. The most commonly identified causes were cerebrovascular disease (20%), chronic alcohol abuse (10%), tumors of central nervous system (6.3%), neurocysticercosis (6.3%) and post-traumatic epilepsy (2.5%). Our data are compared with those from the previous literature, and the value of cranial CT in the investigation of this clinical condition is discussed.
Subject(s)
Epilepsy/etiology , Adult , Age Factors , Catchment Area, Health , Humans , Middle Aged , Prospective Studies , Rural Health , SpainABSTRACT
The existence of thromboangiitis obliterans has been questioned for some years. However, it is now accepted as a specific condition within the wide group of vasculitis. We report a patient with this condition, who, as usual, was a male smoker. The illness presented with thrombophlebitis migrans, which is an uncommon initial feature. The patient also had small vessel cutaneous vasculitis, which is an extremely uncommon association. We report the case and discuss some aspects of the etiology and pathogenesis of the disease.
