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Fevrier A, Dufour PA. Eosinophilic Fasciitis Illustrated by 18 F-FDG PET/CT. Clin Nucl Med 2024; 49:e188-e190. [PMID: 38377376 DOI: 10.1097/rlu.0000000000005094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
ABSTRACT Eosinophilic fasciitis is a rare sclerodermiform disease characterized by upper and lower limb edema. We present the case of a 71-year-old woman currently hospitalized for painful lower limb edema. Laboratory tests reveal moderate eosinophilia (0.8 g/L) and an inflammatory syndrome. Abdominopelvic ultrasound reveals no abnormalities. In light of the unexplained inflammatory syndrome, a 18 F-FDG PET/CT scan currently shows intense hypermetabolism of the fasciae in the lower and upper limbs. Following an MRI, a biopsy is performed, and the anatomopathology currently confirms eosinophilic fasciitis.
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Affiliation(s)
- Agathe Fevrier
- From the Nuclear Medicine, University Hospital of Angers
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2
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Gerritzen N, Ziob J, Brossart P, Schäfer VS. [Imaging of eosinophilic fasciitis in ultrasound and MRI (magnetic resonance imaging): a case report]. Z Rheumatol 2024; 83:134-138. [PMID: 35575828 PMCID: PMC10902094 DOI: 10.1007/s00393-022-01207-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 11/26/2022]
Abstract
Eosinophilic fasciitis (EF, also known as Shulman syndrome) is an uncommon connective tissue disease characterized by inflammatory thickening of the fasciae as well as swelling and hardening of the skin. It mostly affects the lower extremities. Swollen and indurated skin, together with the groove sign, are typical clinical signs. So far, biopsy evidence of inflammation and thickening of the fascia has been the gold standard for diagnosis. Magnetic resonance imaging (MRI) is mentioned in the literature as an alternative method for confirming the diagnosis. We present a case of asymmetric EF in a 54-year-old German male. He came with painful induration of the right forearm, with a characteristic groove sign and limitation of motion of the right hand. The blood count revealed eosinophilia with 0.57 G/l or 9.6% (normal: 0.05-0.5 G/l and 0.5-5.5%), ANA and ENA were negative. The diagnosis was confirmed histologically and we were able to detect a thickened fascia in MRI and ultrasound imaging. The EF also appeared in the left lateral malleolus during the course of the illness. Treatment was carried out with prednisolone and methotrexate.
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Affiliation(s)
- Nicolas Gerritzen
- Medizinische Klinik III, Onkologie, Hämatologie, Rheumatologie und klinische Immunologie, Universitätsklinikum Bonn, Venusberg Campus 1, 53127, Bonn, Deutschland
| | - Jana Ziob
- Klinik und Poliklinik für Dermatologie und Allergologie, Universitätsklinikum Bonn, Bonn, Deutschland
| | - Peter Brossart
- Medizinische Klinik III, Onkologie, Hämatologie, Rheumatologie und klinische Immunologie, Universitätsklinikum Bonn, Venusberg Campus 1, 53127, Bonn, Deutschland
| | - Valentin S Schäfer
- Medizinische Klinik III, Onkologie, Hämatologie, Rheumatologie und klinische Immunologie, Universitätsklinikum Bonn, Venusberg Campus 1, 53127, Bonn, Deutschland.
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3
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Sánchez-Toscano JA, Ruiz-Beltrán AM, Arias-Godínez JA, Rodríguez-Zanella H, Melendez-Ramirez G. Endomyocardial fibrosis secondary to eosinophilia due to parasitism. Eur Heart J Cardiovasc Imaging 2024; 25:e109. [PMID: 37947194 DOI: 10.1093/ehjci/jead282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 10/23/2023] [Indexed: 11/12/2023] Open
Affiliation(s)
- J Alberto Sánchez-Toscano
- Department of Echocardiography and Noninvasive Hemodynamics, Ignacio Chávez National Institute of Cardiology, Juan Badiano No. 1 Tlalpan, 14080 Mexico City, Mexico
| | - A Maximiliano Ruiz-Beltrán
- Department of Echocardiography and Noninvasive Hemodynamics, Ignacio Chávez National Institute of Cardiology, Juan Badiano No. 1 Tlalpan, 14080 Mexico City, Mexico
| | - J Antonio Arias-Godínez
- Department of Echocardiography and Noninvasive Hemodynamics, Ignacio Chávez National Institute of Cardiology, Juan Badiano No. 1 Tlalpan, 14080 Mexico City, Mexico
| | - Hugo Rodríguez-Zanella
- Department of Echocardiography and Noninvasive Hemodynamics, Ignacio Chávez National Institute of Cardiology, Juan Badiano No. 1 Tlalpan, 14080 Mexico City, Mexico
| | - Gabriela Melendez-Ramirez
- Department of Cardiac Magnetic Resonance, Ignacio Chávez National Institute of Cardiology, Juan Badiano No. 1 Tlalpan, 14080 Mexico City, Mexico
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4
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Chen Y, Ji M, Shi J, Qiao Z, Tang L, Yang Z. The clinical and imaging features of eosinophilic cystitis in children: a case series study. Int Urol Nephrol 2024; 56:363-371. [PMID: 37782435 DOI: 10.1007/s11255-023-03811-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/15/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Eosinophilic cystitis (EC) is rare in children and remains poorly understood. Our aim was to analyse the clinical and imaging features of eosinophilic cystitis in children. METHODS A retrospective review of histologically confirmed eosinophilic cystitis between January 2008 and December 2022 was performed, including patient age, sex, symptoms, laboratory examination, radiology, treatment and outcome. RESULTS Twelve children (two girls, 10 boys; age range: 3-12 years, mean age: 7.2 years) were included in the study. Urinary irritation symptoms (10/12), haematuria (5/12) and hypogastralgia (3/12) were the most common symptoms. Five patients had a history of allergies, six patients had elevated serum IgE, nine patients had elevated peripheral eosinophils and six patients had positive microscopic haematuria. Radiology revealed diffuse homogeneous or inhomogeneous thickening in seven patients, localised thickening in three patients, and solitary tumour-like lesions in the other two patients. Preservation of the mucosal line and bladder wall layering were observed in eleven patients, and perivesical exudation and small vessel dilatation were observed in ten patients. All four patients with delayed scans showed obvious delayed enhancement. One patient showed low signal intensity on T2-W imaging. All patients received antihistamine, antibiotic and/or corticosteroid therapy and two tumour-like patients underwent transurethral resection. Nine patients achieved complete response and three patients achieved partial response. CONCLUSION The clinical and imaging manifestations of EC in children have relative characteristics; when urologist and radiologist confronted with similar cases, EC should be considered. The final diagnosis depends on pathological biopsy.
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Affiliation(s)
- Yanan Chen
- Department of Radiology, Shanghai Pulmonary Hospital, 507 Zhengmin Rd., Shanghai, 200082, China
| | - Min Ji
- Department of Radiology, Children's Hospital of Fudan University, 399 Wanyuan Rd., Shanghai, 201100, China
| | - Jingyun Shi
- Department of Radiology, Shanghai Pulmonary Hospital, 507 Zhengmin Rd., Shanghai, 200082, China
| | - Zhongwei Qiao
- Department of Radiology, Children's Hospital of Fudan University, 399 Wanyuan Rd., Shanghai, 201100, China
| | - Liangfeng Tang
- Department of Urology, Children's Hospital of Fudan University, 399 Wanyuan Rd., Shanghai, 201100, China
| | - Zhiming Yang
- Department of Radiology, Children's Hospital of Fudan University, 399 Wanyuan Rd., Shanghai, 201100, China.
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5
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Cleva M, Ennio B, Ferdinando B, Massimo V. Eosinophilic cystitis: a case report of a pseudotumoral lesion. J Ultrasound 2023; 26:935-937. [PMID: 37589872 PMCID: PMC10632338 DOI: 10.1007/s40477-023-00816-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 07/22/2023] [Indexed: 08/18/2023] Open
Abstract
Eosinophilic cystitis is a rare inflammatory disorder of the bladder, characterized by eosinophilic infiltration of the bladder wall, fibrosis of the mucosa, and muscle necrosis. Ultrasonography, when performed, shows a pseudotumoral mass that can be mistaken for malignancy. We report a case of a woman referred to our department in which an ultrasound showed a bladder mass and the biopsy demonstrated the presence of eosinophilic cystitis. The patient was treated with medical treatment and the outcome was favorable with the disappearance of symptoms and no recurrence at controls. We carry a literature review of cystitis eosinophilic, the ultrasound appearance, and therapeutic modalities.
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Affiliation(s)
- Mirco Cleva
- Radiological Department, Sant'Antonio Abate Hospital ASUFC, Via Giobatta Morgagni, 20, 33028, Tolmezzo, UD, Italy.
| | - Bruschi Ennio
- Radiological Department, Sant'Antonio Abate Hospital ASUFC, Via Giobatta Morgagni, 20, 33028, Tolmezzo, UD, Italy
| | | | - Valentino Massimo
- Radiological Department, Sant'Antonio Abate Hospital ASUFC, Via Giobatta Morgagni, 20, 33028, Tolmezzo, UD, Italy
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Shahriari N, Mazori DR, Shahriari M, Taylor D, Shaw K, LaChance AH, Femia AN, Vleugels RA. Utility of magnetic resonance imaging in the diagnosis of eosinophilic fasciitis: A multicenter retrospective cohort study. J Am Acad Dermatol 2023; 89:1313-1315. [PMID: 37659455 DOI: 10.1016/j.jaad.2023.08.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/09/2023] [Accepted: 08/23/2023] [Indexed: 09/04/2023]
Affiliation(s)
- Neda Shahriari
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
| | - Daniel R Mazori
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - Mona Shahriari
- Central Connecticut Dermatology, Cromwell, Connecticut; Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Dustin Taylor
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Katharina Shaw
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Avery H LaChance
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alisa N Femia
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - Ruth Ann Vleugels
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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7
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Bai M, Hou M. A case of hepatic eosinophilic infiltration: CT and MRI findings. Asian J Surg 2023; 46:4679-4680. [PMID: 37301622 DOI: 10.1016/j.asjsur.2023.05.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 05/16/2023] [Indexed: 06/12/2023] Open
Affiliation(s)
- Miaomiao Bai
- Department of Radiology, The Second Hospital of Dalian Medical University, 467 Zhong Shan Road, Dalian, 116023, People's Republic of China
| | - Meidan Hou
- Department of Radiology, The Second Hospital of Dalian Medical University, 467 Zhong Shan Road, Dalian, 116023, People's Republic of China.
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8
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Austin A, Asher E, Knapik JA, Trillo-Alvarez C, Mehta HJ. Green Pleural Effusion Secondary to Eosinophilic Autofluorescence. Am J Respir Crit Care Med 2023; 208:e35-e36. [PMID: 37339506 DOI: 10.1164/rccm.202210-1984im] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 06/20/2023] [Indexed: 06/22/2023] Open
Affiliation(s)
- Adam Austin
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, and
| | - Evan Asher
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, and
| | - Jacquelyn A Knapik
- Department of Pathology, Immunology, and Laboratory Medicine, University of Florida College of Medicine, Gainesville, Florida
| | - Cesar Trillo-Alvarez
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, and
| | - Hiren J Mehta
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, and
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9
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Keshavamurthy C, Bansal P. Dystrophic calcinosis in eosinophilic fasciitis. Clin Rheumatol 2023; 42:311-312. [PMID: 36117199 DOI: 10.1007/s10067-022-06378-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/05/2022] [Accepted: 09/13/2022] [Indexed: 01/26/2023]
Affiliation(s)
- Chandana Keshavamurthy
- Department of Rheumatology, Ochsner Medical Center, 1514 Jefferson Highway, New Orleans, LA, 70121, USA
| | - Pankaj Bansal
- Department of Rheumatology, Mayo Clinic Health System, 1400 Bellinger Street, Eau Claire, WI, 54701, USA.
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10
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Mino T, Sakaguchi H, Hasegawa I, Takeda A, Yoshizaki T, Abe T, Itoh Y. Multiple Cerebral Infarctions Accompanied by Subcortical and Subarachnoid Hemorrhaging in Bilateral Border Zone Areas in a Patient with Eosinophilic Granulomatosis with Polyangiitis. Intern Med 2022; 61:891-895. [PMID: 34483211 PMCID: PMC8987242 DOI: 10.2169/internalmedicine.7999-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Eosinophilic granulomatosis with polyangiitis (EGPA) is often associated with peripheral neuropathy, but reports of central nervous system involvement are quite rare. We herein report a patient with EGPA first identified as having hypereosinophilia who later developed asthma, eosinophilic otitis media, sinusitis, and hemorrhagic colitis. She subsequently developed hemiparesis. Head magnetic resonance imaging revealed multiple cerebral infarctions with subcortical and subarachnoid hemorrhaging colocalized at the bilateral border zone areas. She was diagnosed with EGPA-induced stroke and successfully treated with oral prednisolone. Inflammation in the small cerebral arteries in EGPA may induce bilateral border zone infarction with colocalizing subcortical and subarachnoid hemorrhaging.
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Affiliation(s)
- Toshikazu Mino
- Department of Neurology, Osaka City University Graduate School of Medicine, Japan
| | - Hiroka Sakaguchi
- Department of Neurology, Osaka City University Graduate School of Medicine, Japan
| | - Itsuki Hasegawa
- Department of Neurology, Osaka City University Graduate School of Medicine, Japan
| | - Akitoshi Takeda
- Department of Neurology, Osaka City University Graduate School of Medicine, Japan
| | - Takahito Yoshizaki
- Department of Neurology, Osaka City University Graduate School of Medicine, Japan
| | - Takato Abe
- Department of Neurology, Osaka City University Graduate School of Medicine, Japan
| | - Yoshiaki Itoh
- Department of Neurology, Osaka City University Graduate School of Medicine, Japan
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11
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Primitivo A, Madeira N, Lopez D, Afonso D. Eosinophilic fasciitis (Shulman disease) with clinical, imaging and pathological correlation. BMJ Case Rep 2021; 14:e246151. [PMID: 34969795 PMCID: PMC8719132 DOI: 10.1136/bcr-2021-246151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2021] [Indexed: 11/04/2022] Open
Abstract
Eosinophilic fasciitis (EF) is a rare subacute fibrosing disorder of unknown aetiology, characterised by thickening of the muscular fascia and subcutaneous tissue, leading to swelling of limbs and trunk and sparing fingers and toes. Eosinophilic infiltration and degranulation may prompt tissue damage and consequent fibrosis due to the accumulation of collagen and extracellular matrix proteins. MRI is the best imaging modality for diagnosis, depicting fascial thickening and enhancement. MRI may also have a significant role in excluding alternative diagnosis and guiding the skin-muscle biopsy.We report a case of EF with clinical and pathological correlation, highlighting the diagnostic value of MRI for early diagnosis and further treatment.
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Affiliation(s)
- Ana Primitivo
- Radiology, Hospital Beatriz Ângelo, Loures, Portugal
| | - Nathalie Madeira
- Reumatology, Instituto Português de Reumatologia, Lisboa, Lisboa, Portugal
| | - Dolores Lopez
- Anatomical Pathology, Centro Hospitalar Lisboa Norte EPE, Lisboa, Lisboa, Portugal
| | - Diana Afonso
- Department of Radiology, Hospital da Luz, Lisboa, Lisboa, Portugal
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12
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Abstract
INTRODUCTION Eosinophilic gastroenteritis is an uncommon disorder, characterized by eosinophilic infiltration of the gastrointestinal tract. Clinical presentations are variable. It depends on the involvement of GI layer. Eosinophilic ascites is a rare presentation of eosinophilic gastroenteritis and is often associated with the serosal form. CASE PRESENTATION In this paper, we present a 26-year-old male with EGE who presented with massive hemorrhagic ascites and was successfully treated with steroids. CONCLUSION The diagnosis of eosinophilic gastroenteritis requires histopathological examination and is often made after the exclusion of other possible causes of eosinophilia. EGE should be considered in a patient with unexplained hemorrhagic ascites.
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Affiliation(s)
| | | | - Hong Shen
- Department of Gastroenterology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
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13
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Hayashida S, Sato S, Shimada Y, Tsuzura H, Ikeda Y, Takahashi S, Sato S, Amano N, Murata A, Nagahara A, Genda T. Eosinophilic Gastroenteritis in an Ulcerative Colitis Patient During Treatment with Tumor Necrosis Factor-alpha Antagonist. Intern Med 2020; 59:1977-1981. [PMID: 32801271 PMCID: PMC7492116 DOI: 10.2169/internalmedicine.4554-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
A 45-year-old man with steroid-dependent ulcerative pancolitis was hospitalized with frequent diarrhea, abdominal pain and distension 3 months after induction of golimumab, a tumor necrosis factor-alpha antagonist. Computed tomography showed wall thickening from the stomach to the colon and massive ascites. Peripheral blood test revealed eosinophilia. A large number of eosinophils were observed in the ascites fluid. Although esophagogastroduodenoscopy showed no abnormal findings and colonoscopy showed ulcerative colitis with a Mayo endoscopic subscore of 1, eosinophil infiltration was histologically observed. Based on these findings, we diagnosed him with eosinophilic gastroenteritis and started prednisolone. Consequently, his eosinophil counts and abdominal symptoms dramatically improved.
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Affiliation(s)
- Sho Hayashida
- Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Japan
| | - Shunsuke Sato
- Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Japan
| | - Yuji Shimada
- Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Japan
| | - Hironori Tsuzura
- Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Japan
| | - Yuji Ikeda
- Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Japan
| | - Sho Takahashi
- Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Japan
| | - Sho Sato
- Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Japan
| | - Nozomi Amano
- Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Japan
| | - Ayato Murata
- Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Japan
| | | | - Takuya Genda
- Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Japan
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14
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Narváez J, Juarez P, Morales Ivorra I, Rodriguez Bel L, Rodriguez Moreno J, Romera M. [ 18F] FDG PET/CT may be a useful adjunct in diagnosis of eosinophilic fasciitis. Reumatol Clin (Engl Ed) 2019; 15:e142-e143. [PMID: 29074338 DOI: 10.1016/j.reuma.2017.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 09/07/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Javier Narváez
- Department of Rheumatology, Hospital Universitario de Bellvitge-IDIBELL, Barcelona, Spain.
| | - Pablo Juarez
- Department of Rheumatology, Hospital Universitario de Bellvitge-IDIBELL, Barcelona, Spain
| | - Isabel Morales Ivorra
- Department of Rheumatology, Hospital Universitario de Bellvitge-IDIBELL, Barcelona, Spain
| | - Laura Rodriguez Bel
- PET Unit, Institut de Diagnòstic per la Imatge (IDI), Hospital Universitario de Bellvitge-IDIBELL, Barcelona, Spain
| | - Jesus Rodriguez Moreno
- Department of Rheumatology, Hospital Universitario de Bellvitge-IDIBELL, Barcelona, Spain
| | - Montserrat Romera
- Department of Rheumatology, Hospital Universitario de Bellvitge-IDIBELL, Barcelona, Spain
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15
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Abstract
Both autoimmune hepatitis (AIH) and eosinophilic fasciitis (EF) are known to be complicated by other autoimmune diseases. However, AIH complicated by EF has never been reported. We experienced a 58-year-old man with AIH complicated by EF. He was admitted to our hospital with acute hepatic injury and edema of the legs in April 201X. The etiologies of these symptoms were histologically proven as AIH and EF. The administration of prednisolone (PSL) drastically improved his liver injury and edema of the legs. When we make a diagnosis of AIH, we should carefully evaluate the physical findings, including the appearance of the legs, in order to detect other coexisting autoimmune diseases.
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Affiliation(s)
- Shohei Asada
- Department of Internal Medicine, Saiseikai Chuwa Hospital, Japan
| | - Akitoshi Douhara
- Department of Internal Medicine, Saiseikai Chuwa Hospital, Japan
| | - Koji Murata
- Department of Internal Medicine, Saiseikai Chuwa Hospital, Japan
| | - Koji Yanase
- Department of Internal Medicine, Saiseikai Chuwa Hospital, Japan
| | | | - Hitoshi Yoshiji
- Third department of Internal Medicine, Nara Medical University, Japan
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16
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Harada T, Kawasaki Y, Tsukada A, Osawa Y, Takami H, Yamaguchi K, Kurai J, Yamasaki A, Shimizu E. Bronchodilator Reversibility Occurring during the Acute Phase of Paragonimiasis westermani Infection. Intern Med 2019; 58:297-300. [PMID: 30146559 PMCID: PMC6378150 DOI: 10.2169/internalmedicine.0401-17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
A 43-year-old woman was referred to our hospital with peripheral blood hypereosinophilia and abnormal chest X-ray findings. Her pleural effusion revealed hypereosinophilia and a low glucose level. She was diagnosed with pulmonary paragonimiasis based on an elevated antibody level of Paragonimiasis westermani. Although she had no medical history of allergic disorders, a pulmonary function test revealed bronchodilator reversibility. After praziquantel therapy, her symptoms, hypereosinophilia in peripheral blood, and pleural effusion were improved. A repeated pulmonary function test after praziquantel therapy showed a negative bronchodilator response. Pulmonary paragonimiasis may induce bronchodilator reversibility during the acute phase of infection.
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Affiliation(s)
- Tomoya Harada
- Division of Medical Oncology and Molecular Respirology, Faculty of Medicine, Tottori University, Japan
- Division of Respirology, Tsuyama Daiichi Hospital, Japan
| | - Yuji Kawasaki
- Division of Respirology, Tsuyama Daiichi Hospital, Japan
| | - Akira Tsukada
- Department of Clinical Laboratory, Tsuyama Daiichi Hospital, Japan
| | - Yoichi Osawa
- Department of Clinical Laboratory, Tsuyama Daiichi Hospital, Japan
| | - Hiroki Takami
- Division of Respirology, Tsuyama Daiichi Hospital, Japan
| | - Kosuke Yamaguchi
- Division of Medical Oncology and Molecular Respirology, Faculty of Medicine, Tottori University, Japan
| | - Jun Kurai
- Division of Medical Oncology and Molecular Respirology, Faculty of Medicine, Tottori University, Japan
| | - Akira Yamasaki
- Division of Medical Oncology and Molecular Respirology, Faculty of Medicine, Tottori University, Japan
| | - Eiji Shimizu
- Division of Medical Oncology and Molecular Respirology, Faculty of Medicine, Tottori University, Japan
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17
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Affiliation(s)
- R J Popert
- Department of Urology, St Bartholomew's Hospital, London
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18
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Abstract
The clinical course of hepatic eosinophilic abscess (HEA) induced by malignant tumors is not well-known; however, it is considered to be a benign hepatic lesion. HEA is difficult to diagnose by imaging alone and a pathological examination is generally needed, particularly in patients with malignant tumors, because the radiological findings can be similar to those of metastasis. We report a case of multiple HEAs with eosinophilia and sigmoid colon cancer that was difficult to diagnose without a pathological examination. After the resection of the sigmoid colon cancer, the patient's eosinophilia was quickly ameliorated and the HEAs disappeared within 6 months.
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Affiliation(s)
- Yasuyuki Shigematsu
- Department of Pathology, The Cancer Institute of Japanese Foundation for Cancer Research (JFCR), Japan
- Division of General Oncology, The Cancer Institute Hospital of JFCR, Japan
| | - Hiroaki Kanda
- Department of Pathology, The Cancer Institute of Japanese Foundation for Cancer Research (JFCR), Japan
| | - Toshiya Nagasaki
- Division of Gastroenterology Center, The Cancer Institute Hospital, JFCR, Japan
| | - Takeaki Ishizawa
- Division of Gastroenterology Center, The Cancer Institute Hospital, JFCR, Japan
| | - Yosuke Inoue
- Division of Gastroenterology Center, The Cancer Institute Hospital, JFCR, Japan
| | - Shunji Takahashi
- Division of General Oncology, The Cancer Institute Hospital of JFCR, Japan
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19
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Abstract
OBJECTIVES To investigate the findings of computed tomography (CT) and magnetic resonance imaging (MRI) of focal eosinophilic infiltration (FEI) of the liver. METHODS A retrospective study including 29 patients with confirmed FEI of the liver was performed. We evaluated the lesions' number, distribution, size, shape, margin, attenuation or signal intensity characteristics, the enhancement pattern, and some special features. Spearman correlation analysis was used to analyze the correlation between the number of lesions and the eosinophil counts in peripheral blood. RESULTS In all, 108 lesions were detected in 29 cases, including two cases with single lesion and the remaining 27 cases with multiple lesions. The mean size of all lesions was 34 mm (range, from 3 to 61 mm). 95 (88%) lesions were located in subcapsular parenchyma or surrounding the portal vein. Most (66%) subcapsular lesions were wedge shaped and all lesions surrounding portal vein were round shaped. However, the hepatic parenchymal lesions were irregular or round shaped. All lesions showed ill-defined margins. On pre-contrast CT images, the lesions showed slightly low attenuation or iso-attenuating. On T1-weighted and T2-weighted images, the lesions were slightly iso-/hypointense and hyperintense, respectively. A total of 23 (79.3%) cases were gradually enhanced. Branches of portal vein went through the lesions in all cases; 12 had 'stripe sign' and 16 had 'halo ring sign.' Spearman analysis indicated a significant correlation between the number of lesions and the increased eosinophils in peripheral blood (r = 0.627, p = 0.0003). CONCLUSIONS Special CT and MRI features and increased eosinophils may strongly suggest the diagnosis of FEI of the liver.
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Affiliation(s)
- Bao-Liang Guo
- Department of Radiology, The First People's Hospital of Shunde, Foshan, Guangdong, People's Republic of China
| | - Qiu-Gen Hu
- Department of Radiology, The First People's Hospital of Shunde, Foshan, Guangdong, People's Republic of China
| | - Fu-Sheng Ouyang
- Department of Radiology, The First People's Hospital of Shunde, Foshan, Guangdong, People's Republic of China
| | - Bin Zhang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, People's Republic of China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, People's Republic of China
| | - Yu-Hao Dong
- Department of Radiology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China
| | - Xiao-Ning Luo
- Department of Radiology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China
| | - Zhou-Yang Lian
- Department of Radiology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China.
| | - Shui-Xing Zhang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, People's Republic of China.
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, People's Republic of China.
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20
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Brambatti M, Matassini MV, Adler ED, Klingel K, Camici PG, Ammirati E. Eosinophilic Myocarditis: Characteristics, Treatment, and Outcomes. J Am Coll Cardiol 2017; 70:2363-2375. [PMID: 29096807 DOI: 10.1016/j.jacc.2017.09.023] [Citation(s) in RCA: 167] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 09/01/2017] [Accepted: 09/01/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Eosinophilic myocarditis (EM) is an acute life-threatening inflammatory disease of the heart. Neither large case series nor clinical trials on this specific myocarditis have been reported. OBJECTIVES Based on a systematic revision of all published histologically proven cases, this study aimed to describe the clinical presentation, treatment, and outcome of EM. METHODS The study screened 443 manuscripts in MEDLINE and EMBASE on cases of EM published until June 2017. The authors identified 264 patients and included in the main analysis 179 patients admitted to hospital with histologically proven EM. RESULTS Median age was 41 years (interquartile range: 27 to 53 years) with similar prevalence in both sexes; pediatric cases (≤16 years of age) accounted for 10.1%. The main symptom at presentation was dyspnea (59.4%), with peripheral eosinophilia observed in 75.9%. Median left ventricular ejection fraction at presentation was 35% (interquartile range: 25% to 50%). The disorders most frequently associated with EM were hypersensitivity and eosinophilic granulomatosis with polyangiitis, which accounted for 34.1% and 12.8% of cases, respectively, whereas idiopathic or undefined forms accounted for 35.7% of cases. Steroids were administered in 77.7% of patients. A temporary mechanical circulatory support (n = 30) was instituted in 16.8% of patients. In-hospital death was 22.3% (n = 40), with the highest occurrence in the hypersensitivity form (36.1%; p = 0.026). CONCLUSIONS EM has a poor prognosis during the acute phase, despite a publication bias that could have led to an overestimation of mortality. Associated conditions are identified in approximately 65% of cases. Specific trials and multicenter registries are needed to provide evidence-based treatments to improve in-hospital outcome.
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Affiliation(s)
- Michela Brambatti
- Division of Cardiology, Department of Medicine, University of California San Diego, San Diego, California
| | - Maria Vittoria Matassini
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital, "Ospedali Riuniti," Ancona, Italy
| | - Eric D Adler
- Division of Cardiology, Department of Medicine, University of California San Diego, San Diego, California
| | - Karin Klingel
- Cardiopathology, Institute for Pathology, University Hospital Tübingen, Tübingen, Germany
| | - Paolo G Camici
- San Raffaele Hospital, Milan, Italy; San Raffaele Vita-Salute University, Milan, Italy
| | - Enrico Ammirati
- San Raffaele Vita-Salute University, Milan, Italy; Transplant Center and "De Gasperis" Cardio Center, Niguarda Hospital, Milan, Italy.
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21
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Daniel A, Eugénio G, Serra S, Malcata A, Salvador MJ. Diagnostic utility of Magnetic Ressonance Imaging in Eosinophilic Fasciitis. Acta Reumatol Port 2017; 42:271-272. [PMID: 28379209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
| | | | - Sara Serra
- Centro Hospitalar e Universitário de Coimbra
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22
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23
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Abstract
Eosinophilic myocarditis is a rare form of myocardial inflammation that is characterized by the infiltration of eosinophilic cells into the myocardium. The clinical symptoms of eosinophilic myocarditis are similar to those of acute coronary syndrome, and eosinophilic myocarditis sometimes occurs in combination with bronchial asthma. We herein present a case of eosinophilic myocarditis in which additional time was required to make a definitive diagnosis because the patient received steroid therapy. The diagnosis of eosinophilic myocarditis is challenging, especially when a patient has other inflammatory diseases, such as bronchial asthma. We should pay attention to the possibility that steroid therapy may mask the presentation of eosinophilic myocarditis.
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Affiliation(s)
- Yusuke Watanabe
- Department of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Japan
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24
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Tsujio G, Aomatsu N, Wang E, Yamakoshi Y, Nagashima D, Hirakawa T, Iwauchi T, Nishii T, Morimoto J, Nakazawa K, Tei S, Uchima Y, Takeuchi K. [A Case of Eosinophilic Enteritis Needed to Distinguish from a Tumor of the Small Intestine]. Gan To Kagaku Ryoho 2016; 43:1863-1865. [PMID: 28133157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A 75-year-old woman was diagnosed with aplastic anemia 6 months ago and was under follow-up at our hospital. She had originallypresented to our hospital because of ongoing diarrhea and abdominal pain. Her blood tests showed a rise in inflammatorymarkers (WBC count was 6,900/mL[eosinophil was 1.3%]and CRP was 8.60mg/dL). Her abdominal computed tomography(CT)scan showed gastric wall and small intestine edema as well as ascites. There was no evidence of free air. We diagnosed her with generalized peritonitis and performed an emergencyoperation . Intra-operatively, moderate amounts of yellowish ascitic fluid were noted, as was a diffuse reddening of the small intestine. We performed a partial resection of the small intestine. Histopathological examination showed transmural infiltration of inflammatorycells mainly comprising eosinophilic leukocytes. Eosinophils were also present in the ascitic fluid. Post-operative blood tests confirmed eosinophilic, and we diagnosed her with eosinophilic enteritis. She was started on corticosteroids and her symptoms improved immediately. We report a rare case of eosinophilic enteritis with a review of the pertinent literature.
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25
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Jorge D, Strady C, Guy B, Deslée G, Lebargy F, Dury S. [Multiple pulmonary opacities revealing toxocariasis]. Rev Pneumol Clin 2016; 72:273-276. [PMID: 27368139 DOI: 10.1016/j.pneumo.2016.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 03/04/2016] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Toxocariasis is a parasitosis which complicates the accidental infestation of the humans by larvae of a roundworms belonging of the genus Toxocara. In adults, the discovery is often incidental during a hypereosinophilia check-up. Clinical signs are not specific and depend on affected organs. CASE REPORT We report the case of a 53-year-old-woman who has consulted for a recent cough, after spontaneous resolution of abdominal pain. The laboratory examination isolated an hypereosinophilia and the liver sonography showed two hypoechogenic nodules. The CT-scan found bilateral lung nodules with ground glass halo. Broncho-alveolar lavage identified an eosinophilic alveolitis. Positive serologic results for toxocariasis and western blot results allowed to conclude to the diagnosis of pulmonary and hepatic toxocariasis. CONCLUSION Although rare, pulmonary toxocariasis should be suspect in any lung eosinophilia, especially if the patient has never traveled.
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Affiliation(s)
- D Jorge
- Service des maladies respiratoires, hôpital Maison-Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51 092 Reims cedex, France
| | - C Strady
- Groupe Courlancy, Cabinet d'infectiologie, Clinique Saint-André, 51100 Reims, France
| | - B Guy
- Groupe Courlancy, Cabinet de pneumologie, Clinique Saint-André, 51100 Reims, France
| | - G Deslée
- Service des maladies respiratoires, hôpital Maison-Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51 092 Reims cedex, France; Unité 903, Inserm, 51100 Reims, France
| | - F Lebargy
- Service des maladies respiratoires, hôpital Maison-Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51 092 Reims cedex, France; EA 4683, université de médecine et de pharmacie, 51100 Reims, France
| | - S Dury
- Service des maladies respiratoires, hôpital Maison-Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51 092 Reims cedex, France; EA 4683, université de médecine et de pharmacie, 51100 Reims, France.
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26
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Abstract
Eosinophilic myocarditis may be accompanied by Churg-Strauss syndrome (CSS). We report a case of CSS that was accompanied by myocardial changes in the early stage. A 71-year-old woman complained of mild chest pain at rest, but routine echocardiography did not reveal any endocardial abnormalities. Four months later, the patient was hospitalized due to congestive heart failure with neuropathy of both upper extremities. A diagnosis of eosinophilic myocarditis was made based on the patient's laboratory results and the presence of mural thrombus. This case illustrates that, although early eosinophilic myocarditis is an important differential diagnosis in patients with chest pain, it may be difficult to identify in without an apparent mural thrombus.
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Affiliation(s)
- Nobuyuki Masaki
- Department of Cardiovascular Medicine, National Defense Medical College, Japan
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27
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Han SG, Chen Y, Qian ZH, Yang L, Yu RS, Zhu XL, Li QH, Chen Q. Eosinophilic gastroenteritis associated with eosinophilic cystitis: Computed tomography and magnetic resonance imaging findings. World J Gastroenterol 2015; 21:3139-3145. [PMID: 25780317 PMCID: PMC4356939 DOI: 10.3748/wjg.v21.i10.3139] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 11/07/2014] [Accepted: 12/22/2014] [Indexed: 02/06/2023] Open
Abstract
Eosinophilic gastroenteritis (EG) is a rare, distinct clinical entity, and EG associated with eosinophilic cystitis (EC) is extremely rare and has not been well documented. Here, we report two cases of EG and coexistent EC along with findings from computed tomography (CT) and magnetic resonance imaging (MRI). An 18-year-old male with a history of hematuria, urgency and occasional urodynia for two weeks and a 34-year-old male with a history of abdominal distention for one week were admitted to our hospital. Abdominal contrast-enhanced CT in both patients revealed wall thickening in different parts of the gastrointestinal tract with inhomogeneous reinforcement, coexistent with local or diffuse bladder wall thickening with progressive enhancement, and also showed that the bladder mucosal lining was nondestructive. Pelvic MRI showed that the local or diffuse thickened bladder wall was iso-intense on T1-weighted images, hypo-intense on T2-weighted images, and slightly restricted on diffusion weighted imaging (DWI) in one case. After therapy, the thickened wall of the gastrointestinal tract and urinary bladder had improved markedly in the two cases. To the best of our knowledge, this is the first report on the radiological imaging of EG and coexistent EC by both CT and MRI and the first with DWI findings.
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28
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Raina S, Kaul R, Kaur N, Nakeshwar S, Ranjan A. Pulmonary Infiltrates with Eosinophilia-Allergic Granulomatosis of Churg and Strauss. J Assoc Physicians India 2014; 62:837-838. [PMID: 26259323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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29
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Lee SH, Lee SM, Goo JM, Kim KG, Kim YJ, Park CM. Usefulness of texture analysis in differentiating transient from persistent part-solid nodules(PSNs): a retrospective study. PLoS One 2014; 9:e85167. [PMID: 24416357 PMCID: PMC3885675 DOI: 10.1371/journal.pone.0085167] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 11/24/2013] [Indexed: 01/12/2023] Open
Abstract
Background Early discrimination between transient and persistent par-solid ground-glass nodules (PSNs) at CT is essential for patient management. The objective of our study was to retrospectively investigate the value of texture analysis in differentiating pulmonary transient and persistent PSNs in addition to clinical and CT features. Methods This retrospective study was performed with IRB approval and a waiver of the requirement for patients' informed consent. From January 2007 to October 2009, we identified 77 individuals (39 men and 38 women; mean age, 55 years) with 86 PSNs on thin-section chest CT. Thirty-nine PSNs in 31 individuals were transient and 47 PSNs in 46 patients were persistent. The clinical, CT, and texture features of PSNs were evaluated. To investigate the additional value of texture analysis in differentiating transient from persistent PSNs, logistic regression analysis and C-statistics were performed. Results Between transient and persistent PSNs, there were significant differences in age, gender, smoking history, and eosinophil count among the clinical features. As for thin-section CT features, there were significant differences in lesion size, solid portion size, and lesion multiplicity. In terms of texture features, there were significant differences in mean attenuation, skewness of whole PSN, attenuation ratio of whole PSN to inner solid portion, and 5-, 10-, 25-, 50-percentile CT numbers of whole PSN. Multivariate analysis revealed eosinophilia, lesion size, lesion multiplicity, mean attenuation of whole PSN, skewness of whole PSN, and 5-percentile CT number were significant independent predictors of transient PSNs. (P<0.05) C-statistics revealed that texture analysis incorporating clinical and CT features (AUC, 92.9%) showed significantly higher differentiating performance of transient from persistent PSNs compared with the clinical and CT features alone (AUC, 79.0%). (P = 0.004) Conclusion Texture analysis of PSNs in addition to clinical and CT features analysis has the potential to improve the differentiation of transient from persistent PSNs.
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Affiliation(s)
- Sang Hwan Lee
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Sang Min Lee
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Jin Mo Goo
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Kwang-Gi Kim
- Department of Biomedical Engineering, Division of Basic & Applied Sciences, National Cancer Center, Gyeonggi-Do, Korea
| | - Young Jae Kim
- Department of Biomedical Engineering, Division of Basic & Applied Sciences, National Cancer Center, Gyeonggi-Do, Korea
| | - Chang Min Park
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
- * E-mail:
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30
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Eppenberger M, Hack D, Ammann P, Rickli H, Maeder MT. Acute eosinophilic myocarditis with dramatic response to steroid therapy: the central role of echocardiography in diagnosis and follow-up. Tex Heart Inst J 2013; 40:326-330. [PMID: 23914033 PMCID: PMC3709203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Acute eosinophilic myocarditis is a rare cause of acute heart failure. We present the case of a 32-year-old woman who had presumptive eosinophilic myocarditis as part of a generalized hypersensitivity reaction (Drug Rash with Eosinophilia and Systemic Symptoms [DRESS] syndrome) that exhibited a dramatic response to steroid therapy. We highlight the central role of 2-dimensional and tissue-Doppler echocardiography in the diagnosis of myocarditis and the serial evaluation of left ventricular systolic and diastolic function in this setting.
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31
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Savino A, Salvatore R, Cafarotti A, Cecamore C, De Sanctis S, Angelucci D, Mohn A, Chiarelli F, Pelliccia P. Role of ultrasonography in the diagnosis and follow-up of pediatric eosinophilic gastroenteritis: a case report and review of the literature. Ultraschall Med 2011; 32 Suppl 2:E57-E62. [PMID: 22161612 DOI: 10.1055/s-0031-1281841] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Eosinophilic gastroenteritis (EG) is a rare disease characterized by the infiltration of one or more layers of the digestive tract by eosinophilic leukocytes. The diagnosis is confirmed by histological examination of a characteristic biopsy, but radiological features are useful for diagnostic suspicion. We report the case of an adolescent boy with recurrent epigastric pain, nausea and vomiting, in whom sonographic features and eosinophilia of the peripheral blood suggested the diagnosis of EG. Moreover, we reviewed the radiological features of EG with particular regard to the role of sonography in the diagnosis and follow-up of EG, especially in children. We emphasize the utility of sonography in pediatric patients presenting with gastrointestinal symptoms, since it may provide useful information in a quick, inexpensive and noninvasive way. Ultrasonographic detection of features such as bowel wall thickness, ascites and peritoneal nodules may be largely suggestive of EG and may prevent other invasive exams and abdominal surgery. Ultrasonography can also be easily used in the follow-up of these patients, and may obviate the frequent and potentially dangerous exposure to radiation.
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Affiliation(s)
- A Savino
- Department of Pediatrics, University of Chieti, Chieti, Italy.
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32
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Bally C, Martin C, Kraoua S, Kanaan R, Lacronique J, Dusser D, Burgel PR. [Eosinophilic pleural effusion related to taking valproic acid]. Rev Pneumol Clin 2011; 67:363-366. [PMID: 22137281 DOI: 10.1016/j.pneumo.2010.11.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Revised: 10/11/2010] [Accepted: 11/28/2010] [Indexed: 05/31/2023]
Abstract
Eosinophilic pleural effusions have multiple aetiologies. We report on the case of a 40-year-old man who experienced an eosinophilic pleural effusion with blood hypereosinophilia that occurred nine weeks after a treatment with valproic acid was introduced. Usual aetiologies of eosinophilic pleural effusion were excluded. Once valproic acid was discontinued, both pleural effusion and blood eosinophilia decreased rapidly. The persistence of a residual pleural effusion required the introduction of oral corticosteroids, which resulted in the effusion disappearing completely and rapidly. Valproic acid is a rare cause of eosinophilic pleural effusion. The effusion usually regresses when treatment is discontinued but short-term oral corticotherapy may be necessary in order to heal the patient.
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Affiliation(s)
- C Bally
- Service de pneumologie, hôpital Cochin, Paris, France
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33
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Affiliation(s)
- S Cheriet
- Département de Médecine interne, CHU Rouen, 1 rue de Germont, 76031 Rouen Cedex, France
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34
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Lombardi C, Salmi A, Passalacqua G. An adult case of eosinophilic pyloric stenosis maintained on remission with oral budesonide. Eur Ann Allergy Clin Immunol 2011; 43:29-30. [PMID: 21409859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We describe an isolated eosinophilic pyloric stenosis in a young female. She was referred for abdominal pain, fever, weight loss and eosinophilia. A sonographic examination revealed a concentric pyloric stenosis, with antral palsy and ascites. The endoscopy confirmed the diagnosis of eosinophilic infiltration of the pylorum. After a short course of systemic steroids, the patient was switched to oral budesonide, which effectively maintained a long-term remission. Eosinophilic gastroenteritis limited to pylorum is exceptional in adults, and in our patient it was not associated with allergic other disorders. This case emphasizes the usefulness of sonografy for diagnosis and monitoring, and the clinical efficacy of oral budesonide.
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Affiliation(s)
- C Lombardi
- Allergy Unit, Department of Internal Medicine, Sant'Orsola--Fondazione Poliambulanza Hospital, Brescia
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35
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Rodríguez Jiménez B, Domínguez Ortega J, González García JM, Kindelan Recarte C. Eosinophilic gastroenteritis due to allergy to cow's milk. J Investig Allergol Clin Immunol 2011; 21:150-152. [PMID: 21462806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Eosinophilic gastroenteritis is an uncommon condition that is characterized by infiltration of the gastrointestinal tract by eosinophils. We report the case of a 24-year-old woman who presented 4 episodes of eosinophilic gastroenteritis. Skin prick tests and patch tests with different allergens were all negative. The patient's eosinophil cationic protein (ECP) level was very high. Given that one of the most common causes of this condition is allergy to cow's milk, ECP levels were determined during a diet with and without cow's milk. ECP levels were considerably elevated during the diet with milk, although they returned to normal values several months after milk was withdrawn. The favorable clinical outcome and normalization of ECP levels point to a very probable association with cow's milk in the eosinophilic gastroenteritis presented by our patient.
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36
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Goertz RS, Janka R, Nägel A, Strobel D. Eosinophilic infiltration of the liver and pancreas mimicking metastatic disease. Z Gastroenterol 2010; 48:1138-1140. [PMID: 20839164 DOI: 10.1055/s-0028-1110018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Contrast-enhanced ultrasound (CEUS) has significantly improved the differentiation of hepatic lesions and the detection of liver metastases. Metastases are usually represented as hypoenhanced areas in the late phase and must then be confirmed histologically. Other lesions presenting hypoenhancement in the late phase are abscesses, hepatocellular and cholangiocellular carcinomas, adenomas, avascular necrosis, haematomas and rarely inflammatory masses. The differentiation between these relies on the patient's history, the number of lesions presenting, the B-image morphology and the enhancement pattern in the early phase of CEUS. We report the case of a 49-year-old woman with a in CT assumed pancreatic tumour in whom liver metastases were suspected and investigated by CEUS. In the late phase of this examination hypoenhanced hepatic lesions were observed, prompting us to perform a needle biopsy. The histopathological work-up surprisingly identified the hepatic lesions to be eosinophilic infiltration. After a spontaneous remission we concluded an allergic reaction to a fluoroquinolone.
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37
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Kanoksil W, Larbcharoensub N, Soontrapa P, Phongkitkarun S, Sriphojanart S, Nitiyanant P. Eosinophilic appendicitis caused by Schistosoma japonicum: a case report and review of the literature. Southeast Asian J Trop Med Public Health 2010; 41:1065-1070. [PMID: 21073026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Parasitic appendicitis is uncommon. The authors reviewed the pathology of 4,130 appendices resected over the past 10 years (2000 to 2009). Only one case of eosinophilic appendicitis caused by Schistosoma japonicum was identified. The overall prevalence of schistosomal appendicitis was 0.024%. The case was a 61-year-old woman who presented with right lower quadrant abdominal pain. She had been a farmer in Chumphon and Surat Thani Provinces, which are endemic for schistosomiasis in Thailand. Physical, laboratory and ultrasound examinations were suggestive of acute appendicitis. She underwent emergency appendectomy. Intraoperative findings revealed a ruptured appendix with a fecalith in the appendiceal lumen. The histopathologic diagnosis was suppurative eosinophilic appendicitis with schistosomal ova in the mucosa, submucosa, muscular layer and vascular lumens, identified as S. japonicum eggs. The patient was treated for the parasite with praziquantal. We briefly review the clinicopathologic features and pathogenesis of schistosomal appendicitis.
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Affiliation(s)
- Wasana Kanoksil
- Division of Anatomical Pathology, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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38
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Abstract
Primary eosinophilic enteritis is a rare entity that is characterized by eosinophil infiltration in the different layers of the small bowel. The symptoms depend on the site of infiltration and the layers affected. High blood levels of eosinophils are usually present. Computed tomography plays a fundamental role in the evaluation of this disease. We present a case of primary eosinophilic enteritis diagnosed on the basis of clinical, laboratory, and CT findings.
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Affiliation(s)
- J Ahualli
- Centro Radiológico Luis Méndez Collado, San Miguel de Tucumán, Tucumán, República Argentina.
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Murata A, Akahoshi K, Kouzaki S, Ogata D, Motomura Y, Matsui N, Kubokawa M, Honda K, Endo S, Nakamura K. Eosinophilic gastroenteritis observed by double balloon enteroscopy and endoscopic ultrasonography in the whole gastrointestinal tract. Acta Gastroenterol Belg 2008; 71:418-422. [PMID: 19317286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Eosinophilic gastroenteritis is a chronic inflammatory disorder of the gastrointestinal tract characterized by the infiltration of eosinophils. It is a rare disease. There are no reports in the history of eosinophilic gastroenteritis being consecutively observed in the whole gastrointestinal tract by esophagogastroduodenoscopy (EGD), double-balloon enteroscopy (DBE), and endoscopic ultrasonography (EUS). A 66-year-old woman was admitted to our hospital because of abdominal pain and diarrhea. Laboratory findings included peripheral eosinophilia and a high serum immunoglobulin E level. We observed the whole gastrointestinal tract by EGD, DBE (antegrade and retrograde approaches), and EUS. DBE showed slightly edematous and reddish mucosa in the jejunum, ileum, and ascending colon, respectively. EUS in all portion of the gastrointestinal tract demonstrated almost normal five-layered structure without ascites. Histologic examination of the biopsy specimens from the stomach, duodenum, jejunum, ileum, colon and rectum revealed eosinophilic infiltration. No evidence of parasites, granulomas, malignancy, vasculitis or embolism was founded in any of the biopsy specimens. The patient was diagnosed with eosinophilic gastroenteritis with predominant mucosal layer form. She was treated with oral corticosteroid, and her symptoms subsided. To the best of our knowledge, this is the first case of eosinophilic gastroenteritis in which the whole gastrointestinal tract was consecutively observed by EGD, DBE, and EUS.
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Affiliation(s)
- Atsuhiko Murata
- Department of Gastroenterology, Aso Iizuka Hospital, Iizuka, Japan
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40
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Yang LB, Wu WX. Eosinophilic ureteritis: case report. Chin Med J (Engl) 2008; 121:188-189. [PMID: 18272052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Affiliation(s)
- Lin-bin Yang
- Department of Urology, Jiaxing First Hospital, Jiaxing, Zhejiang 314000, China.
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41
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Evason MD, Carr AP. Eosinophilic cystitis in a female German wire-haired pointer. Can Vet J 2007; 48:509-11. [PMID: 17542370 PMCID: PMC1852600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
A 7-month-old, intact female, German wire-haired pointer presented with a 3-week history of stranguria, pollakiuria, and dysuria that was nonresponsive to antibiotics. Two prior episodes of dysuria-stranguria appeared to respond to antibiotic therapy. Bladder wall biopsies revealed eosinophilic cystitis and the dog responded well to medical management.
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Affiliation(s)
- Michelle D Evason
- Small Animal Clinical Sciences Department, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan S7N 5B4.
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42
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Tuilier T, Darii C, Delorme B, Weil D, Aubé C. [Answer to April e-Quid]. J Radiol 2007; 88:702-3. [PMID: 17541367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Affiliation(s)
- T Tuilier
- Département de radiologie, Centre Hospitalo Universitaire, 2 rue Larrey, 49933 Angers Cedex 9
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43
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Affiliation(s)
- Gerhard G Treiber
- Internal Medicine II, Saarland University Hospital, Homburg, Saarland, Germany
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44
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Matsumoto N, Yokoyama K, Nakai K, Yamamoto T, Otani T, Ogawa M, Tanaka N, Iwasaki A, Arakawa Y, Sugitani M. A case of eosinophilic cholangitis: Imaging findings of contrast-enhanced ultrasonography, cholangioscopy, and intraductal ultrasonography. World J Gastroenterol 2007; 13:1995-7. [PMID: 17461504 PMCID: PMC4146980 DOI: 10.3748/wjg.v13.i13.1995] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
A 38-year-old woman was referred to our institution due to epigastralgia. She presented with obstructive jaundice and eosinophilia. Endoscopic retrograde cholangiopancreatography showed diffuse narrowing from the distal common bile duct to the bifurcation of the hepatic ducts. An endoscopic plastic biliary stent was inserted; the specimen obtained from the common bile duct wall revealed dense infiltration by eosinophils. Treatment was started with prednisolone 60 mg daily. The patient’s biliary stenosis and eosinophilia gradually improved. Eosinophilic infiltration in the lungs or stomach is relatively common, but it is rare in the common bile duct. Most of the reported cases of eosinophilic cholangitis presented with eosinophilia; our patient’s eosinophil count was over 1000/mm3. Since our patient had allergies to pollen and house dust, a relationship between the allergies and the eosinophilic cholangitis was suspected, but no cause was identified.
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Affiliation(s)
- Naoki Matsumoto
- Department of Gastroenterology and Hepatology, Nihon University Surugadai Hospital, 1-8-13, Kandasurugadai, Chiyoda-ku, Tokyo 101-8309, Japan.
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45
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Bhutani MS, Moparty B, Chaya CT, Schnadig V, Logrono R. Endoscopic ultrasound-guided fine-needle aspiration of enlarged mediastinal lymph nodes in eosinophilic esophagitis. Endoscopy 2007; 39 Suppl 1:E82-3. [PMID: 17440879 DOI: 10.1055/s-2006-945122] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- M S Bhutani
- Center for Endoscopic Ultrasound and CERTAIN (Center for Endoscopic Research, Training and Innovation),University of Texas Medical Branch, Galveston, Texas, USA.
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Joassin R, Donnay M, Hugé J, Brasseur JP. Intérêt du bilan fonctionnel et de la rééducation dans la fasciite à éosinophile. ACTA ACUST UNITED AC 2006; 49:577-80. [PMID: 16780990 DOI: 10.1016/j.annrmp.2006.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2006] [Accepted: 05/02/2006] [Indexed: 10/24/2022]
Abstract
PURPOSE To evaluate functional assessment and rehabilitation in eosinophilic fasciitis. METHOD Description of a clinical case of eosinophilic fasciitis, including the evolution of functional assessment after treatment with corticotherapy and rehabilitation. CASE REPORT Our case was a 33-year-old patient with major walking disability and pain in the left calf. Biological examination and imaging, including nuclear magnetic resonance and bone scintigraphy, showed inflammation of the adipose and muscular tissues of the posterior area of the leg. Cutaneomuscular biopsy confirmed the diagnosis of eosinophilic fasciitis. Corticotherapy was then instituted in parallel with rehabilitation to limit deficiencies and disability function. DISCUSSION-CONCLUSION Functional assessment used as indicating objective could, in partnership with follow-up of the biological inflammatory syndrome, lead to decreased use of corticoids in iosinophilic fasciitis. Moreover, supplemental rehabilitation could limit deficiencies and the functional disability resulting from the fasciitis.
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Affiliation(s)
- R Joassin
- Service de médecine physique réadaptation et rhumatologie, clinique Saint-Pierre, 9, avenue Reine-Fabiola, 1340 Ottignies, Belgique.
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Tsuburai T, Kawabata Y, Tsurikisawa N, Mitomi H, Oshikata C, Ono E, Ohtomo M, Maeda Y, Taniguchi M, Akiyama K. [Case of eosinophilic bronchitis and bronchiolitis associated with increased level of serum CEA in asthmatics]. Nihon Kokyuki Gakkai Zasshi 2006; 44:742-8. [PMID: 17087343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
A 50-year-old asthmatic woman showed peripheral blood eosinophilia, significantly increased level of CEA in serum (102.5ng/ml), and atelectasis of the right middle lobe on chest radiograph and CT. The level of CEA subsequently increased further, and then decreased with systemic corticosteroid therapy. Pathological findings of surgically biopsied lung showed eosinophilic broncho-bronchiolitis, without malignant cells. Two years later, chest CT demonstrated various findings such as mucoid impaction, peripheral bronchiectasis and centrilobular nodules, but allergic bronchopulmonary mycosis was not proved. These findings suggest that the eosinophilic bronchiolar inflammation in bronchial asthma caused an increase in serum CEA levels and various findings on chest CT.
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Affiliation(s)
- Takahiro Tsuburai
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital
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Furuta K, Adachi K, Kowari K, Mishima Y, Imaoka H, Kadota C, Koshino K, Miyake T, Kadowaki Y, Furuta K, Kazumori H, Sato S, Ishihara S, Amano Y, Honda M, Kinoshita Y. A Japanese case of eosinophilic esophagitis. J Gastroenterol 2006; 41:706-10. [PMID: 16933010 DOI: 10.1007/s00535-006-1827-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2006] [Accepted: 03/26/2006] [Indexed: 02/04/2023]
Abstract
Eosinophilic esophagitis (EE) is a rarely diagnosed condition involving eosinophilic infiltration of the esophageal mucosa. Here we present a case of EE in a 69-year-old Japanese man, who presented with abdominal pain, appetite loss, and a history of bronchial asthma. Laboratory findings included peripheral eosinophilia and an increased serum immunoglobulin E level. Computed tomography showed diffuse severe thickening of the esophageal wall, and a barium esophagogram revealed a small caliber of the middle and lower portion of the esophagus, without normal peristaltic contractions. Endoscopy of the esophagus showed a pale mucosa, with adherent whitish exudates resembling fungal infection, and prominent ring-like contractions. Histologic examination of a biopsy specimen revealed marked eosinophil infiltration into the esophageal mucosa. Endoscopic ultrasonography (EUS) demonstrated marked circumferential thickening of the esophageal submucosal layer, and an esophageal manometry study showed a high percentage of ineffective esophageal peristalsis and high-amplitude esophageal body contractions. EUS findings showed no change even after oral corticosteroid therapy, although the histological findings were improved. This is thought to be the first documented Japanese case of EE. EE should be considered in the differential diagnosis in cases of esophageal motility disturbance, even if the patients do not complain of dysphagia.
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Affiliation(s)
- Koichiro Furuta
- Department of Gastroenterology and Hepatology, Shimane University School of Medicine, 89-1 Enya-cho, Izumo, 693-8501, Japan
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49
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Bachmeyer C, Ammouri W, Ravet N, Lecomte I, Grateau G, Tassart M, Leynadier F. Sténose du pylore compliquant une gastroentérite à éosinophiles chez un adulte. Rev Med Interne 2006; 27:430-1. [PMID: 16519967 DOI: 10.1016/j.revmed.2006.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2005] [Revised: 01/17/2006] [Accepted: 01/18/2006] [Indexed: 10/25/2022]
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50
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Fritz J, Horger M. CT and MRI Diagnosis of Eosinophilic Fasciitis. ROFO-FORTSCHR RONTG 2006; 178:249-52. [PMID: 16508823 DOI: 10.1055/s-2006-933616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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