• Title/Summary/Keyword: Peripheral eosinophilia

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A study on the clinical courses, sigmoidoscopic and histologic findings of allergic proctocolitis (알레르기성 직결장염의 임상상과 내시경 및 조직소견)

  • Lee, Joo Hee;Kim, Sung Shin;Park, Jae Ock
    • Clinical and Experimental Pediatrics
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    • v.51 no.3
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    • pp.276-285
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    • 2008
  • Purpose : Allergic proctocolitis is a major cause of bloody stool in early infancy. This study was aimed at ascertaining the clinical courses, sigmoidoscopic and histologic findings of allergic proctocolitis. We also analyzed the relationship between peripheral eosinophilia, the age at symptom onset, and sigmoidoscopic and histologic findings. Methods : We reviewed 25 infants retrospectively who had sigmoidoscopy and biopsy performed with a clinical diagnosis of allergic proctocolitis from April 2003 to April 2007. Results : The mean age at symptom onset was $15.2{\pm}13.2$ weeks. Fourteen infants (56.0%) were breast fed, one (4.0%) was formula fed, six (24.0%) were on combined formula, and four (16.0%) were on a weaning diet. Peripheral eosinophilia (${\geq}250/mm^3$) was seen in eighteen infants (75.0%), but total serum IgE was increased only in six (24.0%). Sigmoidoscopic findings were variable from normal (8.0%), erythema or edema (20.0%), lymphoid hyperplasia (8.0%), erosion (12.0%), hemorrhage and ulcer (4.0%) to lymphoid hyperplasia with erosion, hemorrhage, or ulcer (48.0%). Histologic findings showed focal infiltration of eosinophils in lamina propria (96.0%) and crypt epithelium (96.0%). In twenty four infants (96.0%), the number of eosinophils in mucosa was increased by a more than 60/10 high power field. There was a negative correlation between peripheral eosinophilia and the age at symptom onset. Among the twelve breast fed infants, bloody stool disappeared in ten (83.0%) with a maternal elimination diet of major food groups, but two improved spontaneously. Conclusion : Allergic proctocolitis should be considered as one of the major causes of bloody stool in healthy appearing infants. To confirm the diagnosis it is necessary to perform sigmoidoscopy and biopsy but histologic findings are more informative than sigmoidoscopic findings. Peripheral eosinophilia was prominent in the infants with an early onset of symptoms. Most infants experienced benign courses and recovered with the elimination of causative foods but did not need exclusive food restrictions.

Eosinophilic Gastrointestinal Disorder Presenting as Intractable Vomiting and Ascites in a Young Girl

  • Kwon, Ji Yoon;Huh, Ji Sun;Je, Bo Kyung;Hong, Kwang Dae;Lee, Jee Hyun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.20 no.3
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    • pp.198-203
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    • 2017
  • Eosinophilic gastrointestinal disorder (EGID) is a rare disease in children that affects the bowel wall, with eosinophilic infiltration in the absence of any other causes for eosinophilia. The etiology remains unknown, but allergies and immunological imbalance are suspected triggers. We encountered a case of serosal EGID presenting as intractable vomiting and ascites in a 9-year-old girl, after influenza virus infection. Peripheral eosinophilia was not present. The diagnosis was confirmed by biopsy of the bowel wall through laparotomy and endoscopy, and controlled by 2 courses of steroid therapy due to recurring symptoms. Influenza virus infection was assumed to play a role in the onset of EGID through a Th2 response that stimulated eosinophilic infiltration in the GI tract. We therefore report this case along with a literature review.

A Case of Idiopathic Hypereosinophilic Syndrome Associated with Pulmonary Infiltration (폐 침윤을 동반한 특발성 과호산구 증후군 1례)

  • Rhu, Hon-Mo;Kweon, Young-Soo;Chung, Jin-Hong;Lee, Kwan-Ho;Lee, Hyun-Woo;Kim, Dong-Sug;Lee, Sam-Beom
    • Journal of Yeungnam Medical Science
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    • v.11 no.2
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    • pp.375-380
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    • 1994
  • The idiopathic hypereosinophilic syndrome consists of peripheral blood eosinophilia of $1500/mm^3$ or more without a known cause, plus signs and symptoms of organ eosinophilia. The prognosis of HES without treatment is poor. However, about one third of the patients with this syndrome may respond to corticosteroid thrapy. Morever, the majority of the remainder may have a favorable response to hydroxyurea. We present here a case of hypereosinophilic syndrome without any identifiable causes, involving bone marrow, liver, lungs and cervical lymph node. We tried corticosteroid as a treatment but it showed no response. However the hydroxyurea showed good response.

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Subcutaneous Cysticercosis at Abdominal Wall: Case Report (복벽에 발생한 낭미충증 1례)

  • Kim, Eui Sik;Park, Jeong Jun;Noh, Bok Kyun;Hwang, Jae Ha;Kim, Kwang Seog;Lee, Sam Yong
    • Archives of Plastic Surgery
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    • v.33 no.2
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    • pp.249-251
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    • 2006
  • Human cysticercosis is an infestation with C. cellulosae, the larval stage of the tapeworm T. solium. It prevails in regions of poverty and where personal hygiene is poor. They can lodge in almost any tissue, but cysticerci are most frequently found in brain, skeletal muscle, subcutaneous tissues. We experienced a 41-year old male with $5{\times}12cm$ sized movable non tender brownish hard mass at lateral abdominal wall. The laboratory study didn't show any specific symptoms except peripheral blood eosinophilia and positive parasite ELISA screen for cysticercosis. The ultrasonogram revealed multiple ill-defined mixed echoic inflamatory lesion. Excisied cyst showed multiple severe foul-odor gelatinous subcutaneous mass. Microscopic examination disclosed necrotic body with foreign body reaction, massive eosinophilia and dead parasitic organism, compatible with cysticercosis. There was no evidence of recurrence during 12 months follow-up.

Allergic Bronchopulmonary Aspergillosis Associated with Aspergilloma (폐국균종과 동반된 알레르기성 기관지폐 아스페르길루스증 1예)

  • Ryu, Jeon-Su;Baik, Jae-Joong;Kim, Do-Kyun;Kim, Young-Jin;Eom, Woo-Seob;Cho, Jea-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.3
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    • pp.302-307
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    • 2004
  • Aspergilloma and Allergic Bronchopulmonary Aspergillosis(ABPA) are different types of the pulmonary aspergillosis spectrum of diseases. ABPA is an inflammatory disease that causes hypersensitivity to Aspergillus spores growing in the bronchi, which is characterized by asthma, recurrent pulmonary infiltrations or mucoid impaction, eosinophilia and central bronchiectasis. Aspergilloma is a simple colonization of fungus within a cavitary lung lesion, but these diseases rarely coexist. A case of ABPA, coexistent with Aspergilloma, was experienced in a 31 year-old female. The diagnosis was confirmed by the immediate cutaneous reactivity to Aspergillus fumigatus, elevated total IgE antibodies, peripheral eosinophilia, bronchiectasis, growth of Aspergillus species in a sputum culture and radiographic infiltration. Treatment, with prednisone and itraconazole, led to improvement of the respiratory symptoms, reduction of the cavitary lesion and in the total serum IgE level.

A case of cytomegalovirus-negative M$\acute{e}$n$\acute{e}$trier's disease with eosinophilia in a child

  • Son, Keun-Hyung;Kwak, Jeong-Ja;Park, Jae-Ock
    • Clinical and Experimental Pediatrics
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    • v.55 no.8
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    • pp.293-296
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    • 2012
  • M$\acute{e}$n$\acute{e}$trier's disease is a rare form of acquired gastropathy characterized by giant rugal folds in the stomach and protein-losing gastropathy. Children with M$\acute{e}$n$\acute{e}$trier's disease tend to follow a benign self-limited course with symptoms typically completely resolving within 2 to 10 weeks in contrast to the chronic course in adults. A 9-year-old girl presented with a history of gradually worsening abdominal distension, increasing body weight, and abdominal pain for 2 weeks. Physical examination on admission indicated periorbital swelling, pitting edema in both the legs, and abdominal distension with mild diffuse tenderness and shifting dullness. Laboratory tests on admission showed hypoalbuminemia, hypoproteinemia, and peripheral eosinophilia. The test result for anti-cytomegalovirus immunoglobulin M was negative. Increased fecal alpha 1 anti-trypsin excretion was observed. Radiological findings showed massive ascites and pleural effusion in both the lungs. On gastroscopy, large gastric folds, erythema, erosion, and exudation were noted in the body and fundus of the stomach. Microscopic findings showed infiltration of eosinophils and neutrophils in the gastric mucosa. Her symptoms improved with conservative treatment from day 7 of hospitalization and resolved completely.

A CASE REPORT OF KIMURA'S DISEASE IN THE PAROTID REGION (이하선부에 발생한 Kimura's disease에 대한 치험례)

  • Byun, Sung-Soo;Jung, Hwui-Dong;Choi, Young-Dal;Kim, Hyun-Sil;Cha, In-Ho;Kim, Hyung-Jun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.5
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    • pp.554-558
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    • 2007
  • Kimura's disease is a chronic inflammatory disorder presenting regional lymphadenopathy with painless soft tissue mass. Clinically, peripheral eosinophilia and elevated serum IgE levels are observed, and proteinuria associated with renal disease can also be present. Although its etiology is not clearly understood, it occurs predominantly in young Asian males and presents as a deep, subcutaneous mass involving salivary glands of the preauricular and submandibular regions. Spontaneous remission is very rare, and although treatments such as steroid, cytotoxic therapy and irradiation are available, chronic recurrence is very common. As such, surgical excision is regarded as the mainstay of therapy for localized lesions. Histopathologically, Kimura's disease features eosinophilic abscsesses and dense lymphoid aggregates with germinal center. Clinical differential diagnosis of Kimura's disease from other parotid diseases with accompanying lymphadenopathy is often very challenging prior to biopsy. The authors report a case of a 19-year-old male diagnosed with Kimura's disease in the parotid region who underwent surgical excision and was followed up for 6 years, along with a review of related literature.

Clinical Investigation of 11 Cases of Chronic Eosinophilic Pneumonia Reported in Korea (국내에서 보고된 만성 호산구성 폐렴 11예에 대한 임상적 고찰)

  • Woo, Ka-Eun;Chang, Jung-Hyun;Choi, Young-Ah;Joo, Mi-Soon;Seo, Ki-Youl;Shin, Tae-Rim;Cheon, Sean-Hee;Cho, Young-Joo
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.107-115
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    • 1998
  • Background: Chronic eosinophilic pneumonia(CEP) presents with profound systemic symptoms, including fever, malaise, night sweats, weight loss, and anorexia together with localized pulmonary manifestations such as cough, wheeze, and sputum. It is an illness occurring predominantly in women. The chest radiogragh shows fluffy opacities that often have a characteristic peripheral configuration. The hallmark of CEP is the peripheral blood eosinophilia and a prompt response to oral corticosteroid therapy. We investigated characteristics of eleven patients of chronic eosinophilic pneumonia, reported in Korea. Method: There were eleven reports of CEP from 1980 to 1996, including three cases experienced in our hospital. The journals were analysed in respects of clinical history, laboratory, and radiographic findings. Results: 1) Male vs. female ratio is 3 : 8. The peak incidence occurred in forty and fifty decades. The atopic diseases were present in 6 cases. Asthma was the commonest manifestation 2) The presenting symptoms were as follows: cough, dyspnea, sputum, weight loss, fever, general weakness, night sweats, urticaria with the descending incidence. 3) Peripheral blood eosinophilia was present in all patients(mean ; 38.4%) and serum IgE level was elevated in nine patients(mean ; 880IU/ml). Conclusion: The diagnosis of chronic eosinophilic pneumonia is based on classic symptoms, including fever, night sweats, weight loss with a typical roentgenogram of peripheral pulmonary infiltrates and peripheral blood eosinophilia, and that is confimed by lung biopsy and/or bronchoalveolar lavage. Chronic eosinophilic pneumonia is responsive to corticosteroid promptly and recommended at least 6 months of therapy to prevent relapse.

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Paraneoplastic Hypereosinophilia in a Dog with Intestinal T-Cell Lymphoma

  • Ji-Seon Yoon;Hyeona Bae;Hee-Chun Lee;Dong-In Jung;Sang-Ki Kim;Dae Young Kim;DoHyeon Yu
    • Journal of Veterinary Clinics
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    • v.40 no.1
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    • pp.62-67
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    • 2023
  • Paraneoplastic hypereosinophilia, characterized by the infiltration of eosinophils into systemic organs, has rarely been reported in dogs with intestinal lymphoma. A 12-year-old spayed female Maltese with eosinophilia in the peripheral blood and ascites was found to have muscular layer thickening in the small intestine. Histologically, there was transmural infiltration of small to intermediate sized neoplastic lymphocytes that were immunohistochemically CD3-/CD79a-. PCR for antigen receptor rearrangement demonstrated clonal T cell receptor gene population. A moderate number of eosinophils were present along with neoplastic lymphocytes in the small intestine, and eosinophil infiltration was also noted in the abdominal lymph nodes and spleen. The present case reports intestinal T-cell lymphoma with generalized paraneoplastic hypereosinophilia. Clinicians should be aware that hypereosinophilia can be found in the organs, body cavity fluid, and peripheral blood of dogs with intestinal lymphoma.

Peripheral Blood Eosinophil Counts and Serum ECP in Adolescents with Long-term Asthma Remission and Persistent Bronchial Hyperresponsiveness : Comparison with Adolescents with Symptomatic Asthma (기관지 과민성을 가진 장기간 천식 관해 상태의 청소년에서 혈액 내 호산구와 혈청 호산구 양이온 단백에 대한 연구)

  • Kang, Hee;Yoo, Young;Yu, Jinho;Park, Yang;Koh, Young Yull
    • Clinical and Experimental Pediatrics
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    • v.46 no.10
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    • pp.1013-1018
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    • 2003
  • Purpose : Bronchial hyperresponsiveness(BHR) in asthma is thought to be a consequence of underlying airway inflammation. But the mechanism responsible for persistent BHR in adolescents with long-term asthma remission is poorly understood. The aim of this study was to examine whether BHR in adolescents with asthma remission is associated with peripheral blood eosinophilia and/or increased serum levels of eosinophil cationic protein(ECP). Methods : We studied 35 adolescents with long-term asthma remission(neither symptoms nor medication during the previous two years) who have persistent BHR(remission group) and 35 adolescents with symptomatic asthma(symptomatic group) who were matched for methacholine provocative concentration producing a 20% fall in $FEV_1(PC_{20})$ with subjects in the remission group. The peripheral blood eosinophil counts and serum ECP concentrations were compared between these two groups. Correlations between $PC_{20}$ and peripheral blood eosinophil counts or serum ECP concentrations were assessed in these two groups. Results : Peripheral blood eosinophil counts and serum ECP concentrations were significantly lower in the remission group than in the symptomatic group($273{\pm}108$ vs. $365{\pm}178/{\mu}L$; $16.3{\pm}9.4$ vs. $26.5{\pm}15.1{\mu}g/L$, both, P<0.05). $PC_{20}$ was correlated with peripheral blood eosinophil counts and serum ECP concentrations in the symptomatic group(r=-0.385, P=0.022; r=-0.439, P=0.008), but not in the remission group(r=-0.292, P=0.089; r=-0.243, P=0.159). Conclusion : BHR in adolescents with long-term asthma remission is not associated with peripheral blood eosinophilia or an increase in serum ECP concentration, which suggests that BHR in this clinical setting may not be attributed to airway eosinophilic inflammation. Further studies including direct assessment of airway inflammation are needed to confirm this conclusion.