Broncopneumopatia eosinofílica em cães / Eosinophilic bronchopneumopathy in dog

Background: The eosinophilic bronchopneumopathy (EBP) is characterized by pulmonary infiltration with eosinophils. The etiology of canine EBP remains unclear, although hypersensitivity to aeroallergens is suspected. Dogs affected are usually young. The persistent cough is the most common clinical sign, often associated with respiratory difficulty and exercise intolerance. The diagnosis is based on signalment, radiographic and bronchoscopic findings, and the tissue eosiphilic infiltration demonstrated by cytology of bronchoalveolar lavage (BAL). No reports were found in Brazil. The aim of this paper is report four cases of canine BPE, with emphasis on clinical aspects, diagnosis and therapy.Cases: Case 1. A 18-month-old female dog with 12 kg of body weight was presented for consultation with a 60-day history of cough, inappetence and weariness. It presented cough and tachypnea. The complementary exams demonstrated peripheral eosinophilia, bronchointersticial pulmonary pattern on radiography, moderate amount of mucus on bronchoscopy and tissue eosinophilis infiltration on the BAL. The treatment was based on steroids, with improvement of clinical signs. Case 2. A 24-month-old female dog with 16 kg of body weight was presented for consultation with one-year history of cough, inappetence and lethargy. It presented only cough, and in complementary exams showed transitory peripheral eosinophilia, bronchointersticial pattern on radiography and predominantly eosinophilic inflammation on citology of BAL. The therapy was based on steroids, with improvement followed by worsening of signs, with need of readjustment of doses. Case 3. A 8-year-old male dog with 6.2 kg of body weight was presented for consultation with 3-weeks history of productive cough, vomiting and weight loss. The complementary exams showed peripheral eosinophilia, bronchointersticial pulmonary pattern on radiography and eosinophils infiltration on cytology of BAL.[...]

Broncopneumopatia eosinofílica em cães / Eosinophilic bronchopneumopathy in dog

Background: The eosinophilic bronchopneumopathy (EBP) is characterized by pulmonary infiltration with eosinophils. The etiology of canine EBP remains unclear, although hypersensitivity to aeroallergens is suspected. Dogs affected are usually young. The persistent cough is the most common clinical sign, often associated with respiratory difficulty and exercise intolerance. The diagnosis is based on signalment, radiographic and bronchoscopic findings, and the tissue eosiphilic infiltration demonstrated by cytology of bronchoalveolar lavage (BAL). No reports were found in Brazil. The aim of this paper is report four cases of canine BPE, with emphasis on clinical aspects, diagnosis and therapy.Cases: Case 1. A 18-month-old female dog with 12 kg of body weight was presented for consultation with a 60-day history of cough, inappetence and weariness. It presented cough and tachypnea. The complementary exams demonstrated peripheral eosinophilia, bronchointersticial pulmonary pattern on radiography, moderate amount of mucus on bronchoscopy and tissue eosinophilis infiltration on the BAL. The treatment was based on steroids, with improvement of clinical signs. Case 2. A 24-month-old female dog with 16 kg of body weight was presented for consultation with one-year history of cough, inappetence and lethargy. It presented only cough, and in complementary exams showed transitory peripheral eosinophilia, bronchointersticial pattern on radiography and predominantly eosinophilic inflammation on citology of BAL. The therapy was based on steroids, with improvement followed by worsening of signs, with need of readjustment of doses. Case 3. A 8-year-old male dog with 6.2 kg of body weight was presented for consultation with 3-weeks history of productive cough, vomiting and weight loss. The complementary exams showed peripheral eosinophilia, bronchointersticial pulmonary pattern on radiography and eosinophils infiltration on cytology of BAL.[...](AU)

Síndromes de infiltrados pulmonares con eosinofilia / Pulmonary infiltrates with eosinophilia syndrome

Los síndromes de infiltrados pulmonares con eosinofilia (síndromes PIE) constituyen un grupo heterogéneo de desórdenes poco frecuentes, de diferente etiopatogenia y presentación clínica variable. Estos cuadros tienen en común la presencia de infiltrados pulmonares y eosinofilia periférica, en el lavado broncoalveolar y en el intersticio pulmonar; aunque además pueden existir síntomas sistémicos. Actualmente se recomienda clasificar a los síndromes PIE según la etiología en idiopáticos y secundarios. Dentro de los primeros se encuentran la eosinofilia pulmonar simple (síndrome de Loeffler), neumonía eosinofílica aguda, neumonía eosinofílica crónica, síndrome hipereosinofílico idiopático, granulomatosis alérgica o síndrome de Churg- Strauss y granulomatosis broncocéntrica. Los secundarios incluyen la aspergilosis broncopulmonar alérgica, eosinofilia inducida por parásitos (forma más frecuente en pediatría) y por drogas. Los corticoides constituyen el tratamiento de elección, en cambio cuando la etiología son parásitos la terapia debe ser hecha con fármacos antiparasitarios. Se debe tener un alto índice de sospecha en el diagnóstico, debido a la escasa frecuencia que presentan estos síndromes y a la significativa morbilidad y en ocasiones mortalidad, especialmente la neumonía eosinofílica aguda, que se manifiesta frecuentemente con insuficiencia respiratoria severa de etiología desconocida.

Neumonía eosinofílica: presentación de dos casos, agudo y crónico / Eosinophilic pneumonia: Chronic and acute forms

Se presenta dos casos de neumonía eosinofílica idiopática, uno crónico y otro agudo. En el caso clínico 1 se realizó una confirmación anatomopatológica de neumonía eosinofílica idiopática y en el caso clínico 2 se tuvo una neumonia eosinofílica aguda probable. Ambos presentaron tos, fiebre y disnea. El estudio radiográfico reveló lesiones alveolares bilaterales con tendencia a la consolidación. La marcada eosinofilia en sangre periférica fue un dato resaltante que facilitó el diagnóstico. Ambos casos tuvieron muy buena respuesta a la corticoterapia.(Rev Med Hered 2007;18:39-44).

Síndrome de Lõffler / Lõffler’s syndrome

Síndrome de Lõffler é uma pneumonia eosinofílica, caracterizada por infiltrados pulmonares migratórios associados, geralmente, com um aumento do número de eosinófilos no sangue e escarro. Apresentamos um caso de síndrome de Lõffler causada por Strongyloides stercoralis, em um homem de 37 anos de idade. Em virtude da prevalência elevada da estrongiloidíase em nosso país, os autores enfatizam a importância do seu diagnóstico.

Neumonía eosinofílica crónica / Chronic Eosinophilic Pneumonia

Las enfermedades pulmonares eosinofílicas constituyen un variado grupo de patologías que tienen en común la presencia de eosinofilia periférica y tisular e infiltrados radiológicos. Dentro de este grupo se encuentran las neumonías eosinofílicas crónicas. Presentamos dos casos de esta patología en los cuales la biopsia pulmonar no fue necesaria para su diagnóstico. Ambos casos de sexo masculino consultan por síndrome febril y tos, con eosinofilia periférica y eritrosedimentación elevada. En la radiografía y tomografía computada de tórax se observan infiltrados intersticioalveolares periféricos y bilaterales. Examen parasitológico normal. El lavado bronquioalveolar es negativo para células neoplásicas, gérmenes comunes, micológico y tuberculosis, con aumento de Eosinófilos en el mismo. Presentan mejoría clínica y radiológica al tratamiento con corticoides. Actualmente es posible diagnosticar esta patología en base a la presentación clínica típica, los infiltrados radiológicos característicos, el aumento de porcentajes de Eosinófilos en el lavado bronquioalveolar y la rápida respuesta al tratamiento con corticoides, reservando la biopsia pulmonar para casos más dificultosos. (AU)

Neumonía eosinofílica crónica / Chronic Eosinophilic Pneumonia

Las enfermedades pulmonares eosinofílicas constituyen un variado grupo de patologías que tienen en común la presencia de eosinofilia periférica y tisular e infiltrados radiológicos. Dentro de este grupo se encuentran las neumonías eosinofílicas crónicas. Presentamos dos casos de esta patología en los cuales la biopsia pulmonar no fue necesaria para su diagnóstico. Ambos casos de sexo masculino consultan por síndrome febril y tos, con eosinofilia periférica y eritrosedimentación elevada. En la radiografía y tomografía computada de tórax se observan infiltrados intersticioalveolares periféricos y bilaterales. Examen parasitológico normal. El lavado bronquioalveolar es negativo para células neoplásicas, gérmenes comunes, micológico y tuberculosis, con aumento de Eosinófilos en el mismo. Presentan mejoría clínica y radiológica al tratamiento con corticoides. Actualmente es posible diagnosticar esta patología en base a la presentación clínica típica, los infiltrados radiológicos característicos, el aumento de porcentajes de Eosinófilos en el lavado bronquioalveolar y la rápida respuesta al tratamiento con corticoides, reservando la biopsia pulmonar para casos más dificultosos.

Acute eosinophilic pneumonia: a cause of reversible, severe, noninfectious respiratory failure.

We report a case of acute eosinophilic pneumonia associated with adult respiratory distress syndrome in an adolescent. This entity should be considered in the differential diagnosis in previously well children and adolescents who are seen with unexplained respiratory failure and who have many eosinophils in bronchoalveolar lavage fluid. Prompt recognition of this rapidly reversible noninfectious disorder and institution of corticosteroids may be lifesaving.

Antigen-induced pleural eosinophilia is suppressed in diabetic rats: role of corticosteroid hormones

Previous studies have evidenced for the existence of interactive regulatory mechanisms between insulin and steroid hormones in different systems. In this study, we have investigated whether endogenous corticosteroids could be implicated in the hyporeactivity to antigen challenge observed in sensitized diabetic rats. Alloxinated rats showed a long-lasting increase in the blood glucose levels and a reduction in the number of pleural mast cells at 48 and 72 hr, but not at 24 hr after alloxan administration. In parallel, they also showed a significant elevation in the plasma levels of corticosterone together with an increase in the adrenal/body weight ratio. Antigen-evoked eosinophil accumulation appeared significantly reduced in rats pretreated with dexamethasone as weel as in those rendered diabetic 72 hr after alloxan. In the same way, naive animals treated with dexamethasone also responded with a significant decrease in the number of pleural mast cells. Interestingly, when sensitized diabetic rats were pretreated with the steroid antagonist RU 38486 a reversion of the reduction in the allergen-induced eosinophil accumulation was noted. We conclude that the down-regulation of the allergic inflammatory response in diabetic rats is close-related to reduction in mast cell numbers and over expression of endogenous corticosteroids.

Angeitis alérgica granulomatosa

Presentamos el caso de una mujer de 38 años con asma, eosinofilia periférica, sinusitis y opacidades interticiales difusas, bilaterales y fugaces en la radiografía de tórax. El procedimiento diagnóstico fue biopsia pulmonar a cielo abierto donde se encontró una vasculitis eosinofilica características del Síndrome de Churg-Strauss. Comentamos los principales hallazgos clínicos, radiológicos e histopatológicos.

Síndrome de Loffler: um alerta necessário em área endêmica de filariose (artigo de revisäo) / Loffler-Syndrome: A necessary alert in lymphatic filariasis endemic area (Review)

A presente revisäo bibliográfica tem como objetivo alertar os profissionais da área de saúde para as hipereosinofilias transitórias e auto-resolutivas na regiäo do Grande Recife-Brasil, área endêmica de filariose bancroftiana. Os autores fazem consideraçSes gerais (aspectos imunológicos, etiológicos e patológicos) sobre a Síndrome de Loffler (SL), que é largamente distribuída nas áreas tropicais, sub-tropicais e em climas temperados. Ressaltam a importância es síndrome e a eosinofilia pulmonar tropical like (EPT-like), onde os agentes etiológicos seriam o áscaris, stroongyloides e, possívelmente, os Ancilostomídeos. Tanto a EPT como a EPT-like säo de longa duraçäo, podendo cursar em alguns pacientes con níveis de eosinófilos semelhantes a SL, porém, geralmente säo mais elevados. No tocante às diversas formas clínicas de filariose, os autores descartam: (a) relaçäo direta de hipereosinofilia com a presença do verme microfilária e/ou verme adulto, exceçäo de EPT e (b) a validade do teste de imunofluorescência indireta para o diagnóstico da filariose doença ou infecçäo, ainda largamente utilizada na nossa regiäo

Eosinofilia Pulmonar

Foi feita revisão bibliográfica sobre eosinofilia pulmonar,abrangendo síndrome de Loeffler e Eosinofilia tropical. O autor procurou abordar com maior ênfase aspectos que mais evoluiam desde as primeiras notificações de eosinofilia pulmonar,tais como a etipatogenia e o tratamento

Tropical eosinophilia in British Guiana: a preliminary report

This is a report on the clinical aspects of 72 cases of tropical eosinophilia seen at the Georgetown Hospital, British Guiana. The x-ray appearances of these 72 cases plus a further 78 are described. A case that came to post-mortem is described. The report is preceded by a brief review of the history and clinical pathological features of the condition, as well as a suggestion concerning its possible aetiology (AU)