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Introdução: As Gastroenterites Eosinofílicas (GE) são doenças crônicas imunomediadas caracterizadas histologicamente por um aumento de eosinófilos nas diferentes camadas teciduais do trato gastrointestinal. As GE se referem a um grupo de condições, incluindo a esofagite eosinofílica (EE), a gastrite eosinofílica (GE), a enterite eosinofílica (ENE) e a colite eosinofílica (CE). A prevalência da GE nos Estados Unidos é estimada em 22 a 28 por 100.000 pessoas e é maior em crianças

BACKGROUND: Drug Reaction Syndrome with Eosinophilia and Systemic Symptoms (DRESS) is an adverse drug reaction, being life-threatening in 10% of cases. CLINICAL CASE: 15-year-old male patient attended the pediatric emergency department with a clinical history of morbilliform and pruritic exanthema on the face and neck of 9 days of evolution, extending to the thorax and extremities, accompanied by fever of 38.0°C of 1 day of evolution. The patient had a history of atopy and acne vulgaris, treated with minocycline. On admission the hemogram showed leukocytes 16,900 cells/ml, eosinophils 18.2%, neutrophils 6.2%. Blood chemistry revealed: creatinine 1.92 mg/dl, TSGO 45 U/L, TSGP 287 U/L, CRP: 62.8 mg/L and ESR 21 mm/h. It was decided to admit him to the pediatric intensive care unit, since he complies with 7 RegiSCAR points. CONCLUSION: DRESS syndrome is a severe and potentially fatal reaction; its diagnosis is a challenge due to its heterogeneity and clinical variability. It should be taken into consideration after a detailed interrogation that yields the use of suspicious drugs prior to the onset of symptoms, even though its incidence has not been fully described. [ABSTRACT FROM AUTHOR]

The reaction to drugs with eosinophilia and systemic symptoms called DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) is part of a broad spectrum called toxicodermias. The exact incidence is not known in children; However, a mortality rate that can be as high as 10% has been estimated in the literature. We present the case of a teenage patient with a personal history of bipolar affective disorder (BD), who received sertraline, quetiapine and trazodone on an outpatient basis. Due to the presence of hallucinations, lithium was added to the management. Ten days later she went to the emergency department due to the appearance of a skin rash and systemic symptoms, for which a clinical condition secondary to hypersensitivity to medications was suspected. [ABSTRACT FROM AUTHOR]

En los tumores sólidos la hipereosinofilia es un fenómeno raro y se asocia principalmente con carcinomas secretores de mucina. Los tumores tiroideos asociados a neutrofilia y/o eosinofilia se han descrito exclusivamente en pacientes con cáncer anaplásico de tiroides. La eosinofilia asociada con cáncer papilar de tiroides es extremadamente rara y se encuentran muy pocos casos descriptos actualmente. Se ha sugerido que tres citocinas, a saber, la interleucina-3 (IL-3), la interleucina-5 (IL-5) y el factor estimulante de colonias de granulocitos y macrófagos (GM-CSF), pueden actuar como un péptido eosinofílico potencial. Hasta el momento solo se han reportado tres pacientes con cáncer diferenciado de tiroides asociados a eosinofilia, dos de tipo papilar y uno de tipo medular. Paciente de 48 años consultó en el año 2022 por adenopatías cervicales bilaterales de 3 años de evolución asociado a síndrome consuntivo e hipereosinofilia. Se solicitó PET CT que evidenció foco hipermetabólico en lóbulo tiroideo derecho y metástasis ganglionares, pulmonares, óseas y hepáticas; ecografía tiroidea que evidencia en lóbulo derecho nódulo de alta sospecha de malignidad y conglomerado de adenopatías con lavado de aguja positivo para tiroglobulina. Evaluada la hipereosinofilia con valores iniciales de leucocitosis de GB 30310/mm3 (10608/mm3 de eosinófilos) hasta valores máximos de GB 77090/mm3 (eosinófilos 20814/mm3) se interpretó como síndrome paraneoplásico y se inició corticoterapia en dosis inmunosupresoras sin respuesta. Nuestras observaciones presentadas en este artículo están en línea con la mayoría de los estudios que reflejan que la hipereosinofilia paraneoplásica se caracteriza por una enfermedad más avanzada y un mal pronóstico.

Objetivo: Determinar los fenotipos principales de asma en una población de niños asmáticos en Cartagena, Colombia. Métodos: Se reclutaron 107 niños (entre 7 y 17 años), con diagnóstico previo de asma. Se evaluaron biomarcadores de inflamación T2 mediante la medición de FeNO, conteo de eosinófilos en sangre periférica mediante hemocitometría, y la determinación de IgE específica a alergenos de ácaros mediante ELISA. El estudio fue aprobado por el Comité de Ëtica de la Universidad de Cartagena (SGR, Grant BPIN2020000100405). Resultados: La edad media de los pacientes fue de 10,9 años. El 19,6% de los niños no mostró elevación de ninguno de los biomarcadores de inflamación T2 evaluados (FeNO20 ppb + eos >300/ul + IgE específica positiva), clasificando este fenotipo como asma alérgica T2 alta. Se encontró una correlación moderada (Spearman rho=0,44, p

Introduction: Eosinophilic Gastroenteritis (EG) are chronic immune-mediated diseases histologically characterized by an increase in eosinophils in the different tissue layers of the gastrointestinal tract. EG refers to a group of conditions including eosinophilic esophagitis (EE), eosinophilic gastritis (EG), eosinophilic enteritis (ENE) and eosinophilic colitis (EC). The prevalence of EG in the United States is estimated at 22 to 28 per 100,000 people and is higher in children <5 years old. When present in adults, they are more common in the third and fifth decades of life, with equal proportion between men and women. An allergic component is suggested in the pathophysiology of the diseases, with 50 to 70% of patients having concomitant atopic conditions. Methods: we report a case of a patient with eosinophilic gastroenteritis, based on the patient's history and medical records. Results: This case demonstrates the importance of knowing the clinical criteria for the proper diagnosis of this pathology. Conclusion: The wrong treatment prolongs the clinical condition and enhances the appearance of possible complications with a negative impact on quality of life. [ABSTRACT FROM AUTHOR]

Background: The inflammatory process of ulcerative colitis (UC) involves eosinophils. Eosinophils are not only related to the severity of UC but also to clinical improvement. The role of eosinophils in colonic mucosa has not been fully understood. This study aims to determine the correlation between the density of eosinophils in the colonic mucosa and the severity of ulcerative colitis. Method: This is a prospective cross-sectional study with consecutive sampling between August 2020 and July 2021. The subjects were UC inpatients/outpatients at Dr. Sardjito Hospital who met the inclusion and exclusion criteria. The number and location of the biopsies are determined based on a colonoscopy performed by a Gastroenterology-Hepatology Consultant. An Anatomic Pathology Specialist examined the eosinophil colonic tissue. The severity of UC was classified using the Truelove Witts score. Data analysis using a computer program with a p-value < 0.05 was considered statistically significant. Results: There are 3 UC severity categories according to the Truelove Witts score: 22 mild (45.8%), 9 moderate (18.8%), and 17 severe (35.4%). Seven participants (14.6%) had eosinophilia, with a median eosinophilia score of 203.33 cells/microL (0-1470 cells/microL). Five participants (10.4%) with colonic mucosal eosinophilia, with a median value of 14.13 cells/HPF (0-172 cells/HPF). The density of colonic mucosal eosinophils and the severity of UC had a moderate connection (r = 0.396; p = 0.005). Conclusion: There is a significant correlation between the density of eosinophils in the colonic mucosa and the severity of UC. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cirugía Oral y Maxilofacial is the property of Sociedad Espanola de Cirugia Oral y Maxilofacial (SECOM) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

As doenças pulmonares eosinofílicas compõe um grupo heterogêneo de patologias que possuem uma característica em comum: elevado número de eosinófilos nas vias aéreas e no parênquima pulmonar. Uma das formas de eosinofilia pulmonar é a Síndrome de Churg-Strauss (SCS), que é uma doença multissistêmica a qual possui evolução subaguda com três fases clínicas sequenciais: a prodrômica, a eosinofílica e a vasculítica. A hipótese diagnóstica pode ser considerada quando um padrão de opacidades em vidro fosco e consolidações são vistos em paciente com história de asma com eosinofilia.

Foram estudados 52 pacientes adultos e portadores de tumores sólidos malignos, de diversos tipos histológicos, e de localização primária também variada, submetendo-se à poliquimioterapia antineoplásica. Foram distribuídos em 4 grupos: grupo 1 (n= 12) pacientes que receberam radioterapia prévia; grupo II (n= 15) pacientes com invasão neoplásica de serosa; grupo 111 (n 6) pacientes portadores de carcinomas broncogênicos; grupo IV (n= 19) pacientes com tumores sólidos que não se enquadram nos grupos anteriores. Nenhum paciente era portador de doença alérgica ou infecciosa, ou verminose, ou estava em uso de medicamentos que alterassem o número absoluto de eosinófilos. A análise estatística demonstrou a elevação do número de eosinófilos após a quimioterapia antineoplásica nos grupos II e IV. Também, foi observado que a elevação do número de osinófilos correlacionou-se positivamente à melhor responsividade terapêutica à quimioterapia, principalmente no grupo II. Foram aventadas as prováveis causas do fenômeno, relacionando-as à necrose tumoral e/ou a fatores correspondentes à fase de "reconhecimento" antigênico do complexo processo imunológico em relação às neoplasias.

Antecedentes: El síndrome DRESS (Drug reaction with eosinophilia and systemic symptoms) es una reacción idiosincrática, se caracteriza por eosinofilia periférica y síntomas sistémicos: fiebre, exantema, linfadenopatía, hepatitis, linfocitos atípicos y elevación de enzimas hepáticas. La incidencia es de 1 por cada 10,000 exposiciones, mortalidad de 10 a 20%. El tratamiento se basa en la suspensión del fármaco sospechoso y en la aplicación de esteroides. Reporte de caso: Masculino de 42 años con los siguientes antecedentes de importancia. AHF: madre y padre con Diabetes Mellitus tipo 2. APP: Hipertensión Arterial, Diabetes Mellitus tipo 2, y alergia a picadura de abeja. Padecimiento Actual: Lo inicia posterior a 8 días tras la ingesta de hidroxicloroquina por probable infección por SARS-COV-2, con cefalea, edema facial y de cuello, dermatosis descamativa en tronco y extremidades superiores, acude a clínica particular con evolución tórpida enviado a tercer nivel por aumento de edema facial y cuello, que amerito intubación orotraqueal, manejo con esteroides intravenosos y antihistamínicos. Laboratorios a su ingreso: Leucocitos 20090, plaquetas 322 mil, eosinofilia (5%), elevación de enzimas hepáticas y lesión renal aguda, cumpliendo criterios J-SCAR. Se egresa por adecuada evolución con seguimiento por Alergia e Inmunología Clínica, el paciente persiste con lesiones descamativas posterior a 4 semanas y normalización de parámetros de laboratorios. Conclusión: DRESS es una reacción adversa retardada. Es importante la presunción diagnóstica y la relación causal con los fármacos por la alta tasa de mortalidad.

BACKGROUND: DRESS syndrome is a severe adverse reaction to a drug, which can cause multiorgan involvement when it is associated with the ingestion of allopurinol, which is a drug used in clinical practice for the treatment of hyperuricemia and gout, with a mortality rate of 10%. CLINICAL CASE: A 76-year-old female patient who, after taking allopurinol due to hyperuricemia, showed bumby, red, over raised, pruritic lesion on the body and the face. In addition, in the following 24 hours, she also presented edema and desquamation mainly in the face. With the help of complementary tests, such as leukocytosis with eosinophilia, we observed a deterioration of her renal function. However, after the suspension of the drug and the administration of corticosteroids patient improved. CONCLUSIONS: DRESS syndrome has a high risk of lethality; therefore, it is extremely important that physicians take the right steps such as the rapid suspension of drugs as well as therapeutic measurements to help minimize the risk. [ABSTRACT FROM AUTHOR]

Eosinophilic pulmonary diseases encompass a heterogeneous group of pathologies characterized by a shared feature: a high number of eosinophils in the airways and lung parenchyma. One manifestation of eosinophilic pulmonary involvement is Churg-Strauss Syndrome (CSS), a multisystemic disease that follows a subacute course with three sequential clinical phases: prodromal, eosinophilic, and vasculitic. The diagnostic hypothesis can be considered when a pattern of ground-glass opacities and consolidations is observed in a patient with a history of eosinophilic asthma. [ABSTRACT FROM AUTHOR]

Copyright of Revista Colombiana de Psiquiatria is the property of Asociacion Colombiana de Psiquiatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

DRESS (drug reaction syndrome with eosinophilia and systemic symptoms) is a rare drug-induced multisystemic hypersensitivity response that can induce a severe cutaneous adverse reaction that is difficult to diagnose and treat. It frequently manifests as an extensive skin rash, systemic symptoms, lymphadenopathy, visceral organ involvement, and hematological alterations, mainly leukocytosis, eosinophilia, and sometimes atypical lymphocytosis that manifest 2 to 8 weeks after continuous administration of the responsible drug. The most prevalent drugs related with this syndrome are phenytoin, carbamazepine, allopurinol, and abacavir. Some specific human leukocyte antigen (HLA) alleles have been identified that are associated with hypersensitivity to these drugs. The pathophysiology of DRESS syndrome is not yet fully understood; the main hypothesis is a T-cell mediated hypersensitivity response when interacting with the major histocompatibility complex receptor in individuals with genetic susceptibility factors. The criteria of the European Registry of Severe Cutaneous Adverse Reactions to Drugs (RegiSCAR) are the most commonly used for the diagnosis of DRESS syndrome. Drug-induced hypersensitivity syndrome (DiHS), Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and acute generalized exanthematous pustulosis (AGEP) should be considered for any rash that appears following the administration of any drug. Therapy of DRESS includes the elimination of the causative agent as soon as possible, as well as systemic corticosteroids which are the cornerstones of treatment. Steroid-sparing agents such as cyclosporine, intravenous immunoglobulins (IVIGs), and other immunosuppressive agents have been used successfully to contribute to treat- ment. [ABSTRACT FROM AUTHOR]

BACKGROUND: Eosinophilic myocarditis is a disease with multiple described causes, which shows infiltration of eosinophils in the myocardium, associated or not with hypereosinophilia in blood. CLINICAL CASE: An 85-year-old male patient, immunocompetent, with clinical and pathological findings of eosinophilic myocarditis due to strongyloidiasis, a currently uncommon cause. CONCLUSIONS: One of the causes of hypereosinophilia is strongyloidiasis that presents with myocarditis or de novo heart failure. Most fatal infections caused by Strongyloides stercoralis could be prevented with early detection and treatment of asymptomatic chronic infections. [ABSTRACT FROM AUTHOR]

Patient presents in ER with symptoms and history indicative of infectious disease, with muscle pain and double vison being the main complaints. After several consultations, it is decided to admit the patient to the internal medicine ward, where following clinical investigation focused on a differential diagnosis of eosinophilia and myopathy. Paciente acude al servicio de urgencias con un cuadro compatible con patología infecciosa, siendo dolor muscular y visión doble las principales quejas. Tras consultar con diferentes servicios, se decide ingreso en el servicio de medicina interna, donde la investigación clínica se focaliza en un diagnóstico diferencial de eosinofilia y miopatía.

Asthma is a chronic inflammatory disease of the airways characterised by variable and/or reversible obstruction to airflow. Standard treatments include glucocorticoids (either systemic or inhaled), short-acting beta-adrenergic agonists and long-acting beta-adrenergic agonists, and monoclonal antibodies, whereby the latter is reserved for patients with severe uncontrolled asthma (SUA). Omalizumab, mepolizumab, benralizumab and reslizumab have been shown to be effective and safe in the short term for achieving control in SUA. Additionally, it has been demonstrated that good long-term control of this disease can be achieved with omalizumab, with the drug being well-tolerated. Furthermore, dupilumab has also been incorporated to the list of available agents. Other biologics that have been investigated but which have yielded inconclusive results include lebrikizumab, tralokinumab, tezepelumab, fevipiprant and timapiprant. In the light of imminent innovations in treatment and the significant impact these are having, it is essential to consolidate our pathophysiological knowledge of SUA as well as the main drugs currently available, in addition to drugs in the pipeline. [ABSTRACT FROM AUTHOR]

BACKGROUND: DRESS syndrome (drug reaction with eosinophilia and systemic symptoms) is associated with exposure to certain drugs. It is potentially fatal (20%), with significant dermatological manifestations and visceral involvement. The main treatment is the immediate withdrawal of the suspected drug, as well as the use of systemic corticosteroids. CLINICAL CASE: A 61-year-old female patient, who, after two weeks of ampicillin consumption, presented a generalized morbilliform skin rash, non-involving soles and palms, and also itchy and painful symmetrical erythematous plaques with lamellar scaling on the face and edema of lips and oral mucosa. Laboratory tests showed leukocytosis with eosinophilia and lymphocytosis as well as impaired kidney and liver function. The histopathological study described hyperkeratosis, spongiosis, and inflammatory infiltrates in the superficial dermis. CONCLUSIONS: DRESS syndrome is a rare and potentially fatal drug reaction, which should be suspected in the presence of a morbilliform rash, fever, hypereosinophilia, as well as visceral involvement, to establish a timely diagnosis and treatment to avoid complications such as multi-organ failure, as well as mortality. [ABSTRACT FROM AUTHOR]

DRESS (drug reaction with eosinophilia and systemic symptoms) syndrome, also known as DIHS (drug-induced hypersensitivity syndrome), is an adverse and severe drug reaction. It has an estimated incidence of 1 case per 10,000 exposures to anticonvulsants, such as carbamazepine. The pathogenesis is considered type IVb hypersensitivity reaction triggered by the exposure of the related drug. The clinical presentation is characterized by fever, widespread skin lesions, internal organ compromise, a prolonged latent period and clinical course, and by a possible sequential reactivation of various human herpesvirus (HHV). The diagnosis of DRESS and DIHS is based on criteria established by the European Registry of Severe Cutaneous Adverse Reactions (RegiSCAR) and by the Japanese Research Committee on Severe Cutaneous Adverse Reaction (J-SCAR), respectively. Generally, the histopathological characteristics are not specific, as they are described as spongiotic dermatitis and drug reaction that commonly has eosinophils and apoptotic keratinocytes. Initial management requires the identification and prompt withdrawal of the related drug, besides support measures; nevertheless, corticosteroids are the mainstay treatment. The estimated mortality is 10%, primarily due to hepatic dysfunction. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Gastroenterología del Perú is the property of Sociedad de Gastroenterologia del Peru and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background. Kimura's disease is an infrequent inflammatory disorder, of unknown etiology, with few reports outside of Asia. It presents as a nodule or tumor predominantly in the postauricular region, neck and parotid gland. It is histologically characterized by follicular hyperplasia with wellformed mantle zones, preservation of nodal architecture, prominent eosinophilic infiltrate in the germinal centers and interfollicular areas; and associated with elevated levels of IgE and peripheral eosinophilia. Clinical case: We present a case of a 23-year-old man from Mexico, he presented with a recurrent tumor in the right parotid gland, previously treated with surgical resection. Imaging studies were performed and a primary neoplasm of the salivary gland was suspected, he was treated with surgical resection. The histological diagnosis was Kimura's disease. Conclusions: Communication and divulgation of this rare inflammatory disorder expans the knowledge for the differential diagnosis of tumors of the head and neck, and salivary glands, mainly in men with peripheral eosinophilia and elevated IgE; it can sometimes simulate malignant neoplasms, leads to inadequate diagnostic and therapeutic approaches. [ABSTRACT FROM AUTHOR]

Migrant patients share the same diseases as natives, but biological or environmental differences may lead to distinct prevalence and manifestations of certain syndromes. Some common conditions in Primary Care stand out, such as fever, diarrhea, anemia, eosinophilia, and chronic cough, where it is important to have a special consideration. Fever may indicate a serious imported illness, and malaria should always be ruled out. Diarrhea is generally of infectious origin, and in most cases, management is outpatient. Anemia may indicate malnutrition or malabsorption, while eosinophilia may indicate a parasitic infection. Lastly, chronic cough may be a sign of tuberculosis, especially in immigrants from endemic areas. Family medicine holds a privileged position for the comprehensive, culturally sensitive, and person-centered approach to these conditions., (Copyright © 2024 The Authors. Publicado por Elsevier España S.L.U. All rights reserved.)

El síndrome hipereosinofilico (SHE), es un desorden leucoproliferativo caracterizado por eosinofilia mayor de 1500 celulas/mm3 por más de seis meses, ausencia de otras causas de eosinofilia y presencia de signos o síntomas de daño a órganos por la eosinofilia. Es rara en niños y más frecuente en varones, puede ser primaria o secundaria a una serie de enfermedades o drogas. Los eosinófilos producen una infiltración difusa en los órganos, pueden comprometer a cualquier órgano y afectar varios a la vez. La sintomatología depende del órgano afectado. La infiltración cardiaca es la de mayor morbimortalidad. A continuación presentamos un caso clínico de síndrome hipereosinofilico que posteriormente sufre transformación a leucemia linfoblástica aguda (LLA).

The eosinophilic granuloma is defined by dense cellular infiltration of eosinophils, macrophages, and mast cells, in addition to collagenolysis foci. Canine eosinophilic granuloma is a rare inflammatory skin disease that affects the oral mucosa. However, the cutaneous eosinophilic granuloma is more evident and can be found in the scrotum, testicles, perineum, and flanks. The etiology of eosinophilic granuloma in dogs is unclear but allergic processes can originate in granulomatous nodules or plaques. Affected dogs may experience itching, swelling, and, occasionally, pain. The histopathological analysis is necessary for a definitive diagnosis. The present case report described a 12-year-old male dog, Poodle, with a history of swelling, itching, and pain in the scrotum. Complete clinical staging was performed through blood count, biochemistry analysis, thoracic radiographs, abdominal ultrasound, and electrocardiogram. The dog was submitted for surgical removal followed by histopathologic evaluation. Eosinophilic granuloma should be included in the differential diagnosis of solitary masses in the scrotal region. [ABSTRACT FROM AUTHOR]

Las reacciones adversas a medicamentos son tan antiguas como la existencia de estos, la población pediátrica se encuentra expuesta a múltiples fármacos por las patologías propias de este grupo etario, en especial anticomiciales, antibióticos y antiinflamatorios no esteroideos, que son asociados con mayor frecuencia al síndrome de DRESS. La sintomatología clásica se define por la triada de fiebre, exantema, y afectación de órganos, acompañada de eosinofilia, el diagnóstico se basa en la historia clínica, el uso de medicamentos en las últimas seis semanas y los hallazgos de laboratorio. El reconocimiento oportuno de esta entidad patológica, así como del espectro de enfermedades que forman parte del diagnóstico diferencial como el síndrome de Stevens-Johnson, pustulosis exantemática aguda generalizada y las enfermedades exantemáticas de la infancia, cobra gran importancia para el pronóstico del paciente.

Las helmintiasis intestinales son un problema de salud pública en los países tropicales, en especial en los subdesarrollados y en la población de escasos recursos. La infección con estos parásitos origina una respuesta hematológica caracterizada por el aumento de la cantidad de eosinófilos circulantes en sangre periférica y en los tejidos, que se conoce como eosinofilia. En este trabajo se realizó una revisión sistemática de la literatura publicada, en los últimos 25 años sobre la clasificación de la eosinofilia, los helmintos intestinales que la producen, cuáles son los mecanismos inmunológicos que ocurren en el ser humano ante estas parasitosis, así como los mecanismos de evasión del sistema inmunitario utilizados, principalmente, por las formas adultas de éstos parásitos, las reacciones alérgicas asociadas a la activación del sistema inmune, las enfermedades inmunológicas y la pobre respuestas a las vacunas. Por último, se revisa la función del eosinófilo como célula efectora de la inmunidad Th2 contra los helmintos intestinales. Esta revisión está registrada en PROSPERO bajo el número ID 215594

Se presentó una paciente de 74 años de edad, con antecedentes patológicos de diabetes mellitus tipo II e hipertensión arterial, y fumadora. Hacía dos meses había comenzado con tos seca que luego fue húmeda, con expectoración blanquecina y dolor en punta del costado izquierdo, en ocasiones falta de aire, con síntomas generales: astenia, anorexia y disfonía. Se le diagnosticó bronquitis sin resolución total. Los exámenes de laboratorio revelaron eosinofilia asociada a un cáncer de pulmón constatado en estudios imagenológicos, citológico y otros. La eosinofilia y el cáncer de pulmón es una entidad que comparte la presencia de infiltrados pulmonares y un incremento del número de eosinófilos en sangre periférica o tejido pulmonar en algún momento de su evolución. Se concluye que el incremento de los eosinófilos obedece a diversas causas, la eosinofilia y cáncer de pulmón constituye una de las condiciones neoplásicas.

A 74-year-old female patient presented at the medical office, with a history of type II diabetes mellitus, hypertension, and smoker. Two months ago she had started with a dry cough that later became wet, with whitish expectoration and pain in the tip of the left side, sometimes shortness of breath with general symptoms like: asthenia, anorexia and dysphonia. She was diagnosed with bronchitis without complete resolution. Laboratory tests revealed eosinophilia associated with lung and other studies. Eosinophilia and lung cancer is an entity that shares the presence of pulmonary infiltrates and an increasing number of eosinophils in peripheral blood or lung tissue at some point in its evolution. It is concluded that the increase in eosinophils it´s due to various causes. Eosinophilia and lung cancer constitutes one of the neoplastic conditions, and one of the highest incidences in the world.

El granuloma eosinofílico se caracteriza por una infiltración celular densa de eosinófilos, macrófagos y mastocitos, además de focos de colagenólisis. El granuloma eosinofílico canino es una rara enfermedad inflamatoria de la piel que afecta la mucosa oral. Sin embargo, la forma cutánea es más evidente y puede estar en el escroto, los testículos, el perineo y los flancos. La etiología del granuloma eosinofílico en perros no está clara, pero los procesos alérgicos pueden originar nódulos o placas granulomatosas. Los perros afectados pueden presentar picazón, hinchazón y, ocasionalmente, dolor. El análisis histopatológico es necesario para el diagnóstico definitivo. El presente informe del caso describe un perro macho de 12 años, Poodle, con antecedentes de hinchazón, picazón y dolor en el escroto. La estadificación clínica completa se realizó mediante recuento sanguíneo, análisis bioquímico, radiografías torácicas, ultrasonido abdominal y electrocardiograma. El perro fue sometido a extracción quirúrgica seguida de evaluación histopatológica. El granuloma eosinofílico debe incluirse en el diagnóstico diferencial de las masas solitarias en la región escrotal.

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OBJECTIVE: To determine the clinical characteristics of DRESS syndrome in our study population and compare 4 different scoring scales from diagnostic criteria of this syndrome. MATERIALS AND METHODS: Observational, retrospective and cross-sectional study of patients with DRESS syndrome in Argentina. The study included 674 patients who were diagnosed as having an adverse cutaneous drug reaction diagnosed by clinical and histopathology judgment during the period 2007-2020. We emphasized in the comparison of diagnostic criteria: Bocquet, J-SCAR and RegiSCAR (Validation scoring and Notification and inclusion of cases). RESULTS: There were included 18 patients. The research has shown a prevalence of DRESS syndrome among women (average of diagnosis: 34 years old). 8/18 patients had an acute onset (≤ 15 days). Carbamazepine was the most implicated drug. Fever, pruritic rash with polyadenopathy, facial edema, and liver involvement were the most frequent clinical manifestations. At the biochemical level, we found leukocytosis with eosinophilia and increased liver transaminases. Both RegiSCAR were the most effective method to evaluate criteria. CONCLUSIONS: Both RegiSCAR were the most efficient, in special notification and inclusion of cases. We consider of little application in our country the J-SCAR criteria and it should only be considered when VRESS (viral reactivation with eosinophilia and systemic symptoms) is suspected. Finally, we propose modifications in some points of the criteria that we consider unclear. [ABSTRACT FROM AUTHOR]

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BACKGROUND: Drug hypersensitivity syndrome, also known as DRESS syndrome (drug reaction with eosinophilia and systemic symptoms), is an adverse reaction to medications and is life-threatening; dermatological manifestations are diverse and can cause significant multisystemic compromise. Diagnosis is a challenge due to the polymorphous rash of skin lesions, fever and multiorgan commitment. Treatment consists on the immediate withdrawal of the suspicious drug; systemic corticosteroids are the gold standard, depending on the severity, intravenous immunoglobulin or other immunosuppressive drugs can be added. CLINICAL CASE: A 37-year-old female patient, who three weeks after consumption of allopurinol had a generalized and symmetrical dermatosis, consisting of numerous macules that converged with each other to form a morbilliform pattern, with some skin-colored isolated spaces, also some papules that form erythematous-edematous plaques with ill-defined and blurred edges of apparently acute evolution. It was accompanied by itching, dry cough, fever, and adenomegalies. Laboratory tests showed eosinophilia and impaired kidney function. Histopathological study corresponded to interface dermatitis consistent with reactional dermatitis. CONCLUSIONS: It is important to know the clinical manifestations of DRESS syndrome, in order to have its early recognition and timely treatment, since although complete recovery is the usual course, mortality of up to 20-30% has been reported. [ABSTRACT FROM AUTHOR]

A cistite eosinofílica é uma doença inflamatória rara caracterizada por infiltração eosinofílica de todas as camadas da parede da bexiga. Essa enfermidade já foi descrita em adultos, crianças e cães. No entanto, não há um consenso de diretrizes sobre o seu tratamento. Mesmo que as literaturas humana e veterinária mostrem alguma eficácia no manejo com corticosteroides, anti-histamínicos e antibióticos, uma variedade de efeitos colaterais graves e frequentes estão associados à terapia com esteróides. Dessa forma, seu uso é relativamente contra-indicado para pacientes com diabetes mellitus e síndrome de Cushing, por exemplo. Um chow-chow, macho, castrado, de cinco anos e diabético estável foi encaminhado para atendimento com histórico de urina fétida, hematúria macroscópica e disúria não responsiva a antibióticos há 18 meses. A avaliação dos parâmetros físicos estava dentro dos padrões, exceto por desconforto abdominal suprapúbico. O hemograma e o perfil bioquímico estavam dentro dos valores de referência, exceto por eosinofilia periférica leve. Embora a ultrassonografia, a radiografia contratada da bexiga e os achados da urinálise indicassem malignidade, a histopatologia confirmou o diagnóstico definitivo de cistite eosinofílica. O manejo com ciclosporina foi satisfatório, com remissão completa da hematúria. Este relato de caso apresenta o primeiro uso documentado de ciclosporina para o tratamento de cistite eosinofílica, com sucesso, em um cão com diabetes.

El síndrome DRESS es una reacción adversa dermatológica que puede presentarse debido a diversos medicamentos, y constituye uno de los diagnósticos más importantes por encima del síndrome de Stevens-Johnson. Se trata de un caso relacionado con una reacción adversa de muy baja frecuencia, que está documentada en la literatura científica, a varios medicamentos, entre ellos la fenitoína. Por lo mencionado, la publicación de estos casos resulta escasa y limitada. Las principales preocupaciones del paciente relacionadas con su cuadro clínico radicaban en el gran compromiso cutáneo que lo llevó a hospitalización, dolor e incomodidad, por el cual recurrió al manejo tópico generalizado con vaselina. Los hallazgos clínicos relevantes fueron: eosinofilia severa, ulceraciones cutáneas, hepatitis química y fiebre. Con los hallazgos del cuadro clínico y la evaluación de la escala RegiSCAR se hace el diagnóstico de síndrome DRESS inducido por fenitoína. Se suspende la fenitoína, se inicia levetiracetam y se administran corticosteroides y acetaminofén con evolución favorable.

Copyright of Revista de Ciencias Médicas de Pinar del Río is the property of Editorial Ciencias Medicas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Determine the main asthma phenotypes in a population of asthmatic children in Cartagena, Colombia. Methods: 107 children (7 to 17 years old) with a previous diagnosis of asthma were recruited. Biomarkers of T2 inflammation were evaluated by measuring FeNO, eosinophil count in peripheral blood by hemocytometry, and determination of specific IgE to mite allergens by ELISA. The study was approved by the ethics committee of the University of Cartagena (SGR, Grant BPIN2020000100405). Results: The average age of patients was 10,9 years. 19,6% of the children did not show elevation of any of the T2 inflammation biomarkers evaluated (FeNO<20ppb, eos<300/ul, negative specific IgE), so they were considered patients with non-allergic asthma (non-T2). 71,9% of all patients were sensitized to at least one allergen, this phenotype was considered allergic asthma. 30,8% of the patients presented the three elevated biomarkers (FeNO>- 20ppb + eos >300/ul + positive specific IgE), this phenotype was classified as high T2 allergic asthma. A moderate correlation (Spearman rho=0,44, p<0,0001) was found between FeNO values and eosinophil counts. Conclusion: In this study, the following phenotypes were found: allergic asthma, high T2 asthma, and non-allergic asthma. Most patients presented a type 2 inflammatory phenotype with allergic sensitization. In addition to the measurement of specific IgE, the use of FeNO and eosinophil count in peripheral blood help to accurately determine those patients with high T2 asthma phenotypes. [ABSTRACT FROM AUTHOR]

El síndrome de sensibilidad a drogas con eosinofilia y síntomas sistémicos es una reacción de hipersensibilidad que se desencadena por múltiples drogas, tales como antibióticos, antiinflamatorios, anticonvulsivantes que ocurre en el 2,2 % de los pacientes hospitalizados. Su importancia radica en la alta mortalidad, que puede alcanzar hasta un 30 %. Se presenta el caso de un niño de 5 años, con antecedentes de epilepsia diagnosticada, tratada con carbamazepina, que al corto tiempo de iniciar tratamiento anticonvulsivante evolucionó con fiebre de 11 días. Posteriormente aparecieron lesiones cutáneas eritematosas maculopapulares pruriginosas. Se ingresó con el diagnostico de síndrome febril prolongado. Los exámenes de laboratorio revelaron eosinofilia, elevación de pruebas hepáticas y de proteína C reactiva. Se planteó síndrome de sensibilidad a drogas inducido por carbamazepina, tras resultado de la biopsia de piel se suspende el anticomicial, remitiendo así el cuadro, con normalización de eosinófilos y función hepática. El paciente evolucionó sin fiebre y en buen estado general. Se presenta este caso por la baja prevalencia de este síndrome en el Hospital Pediátrico Universitario Paquito González Cueto de Cienfuegos.

Drug reaction syndrome with eosinophilia and systemic symptoms is a reaction of hypersensitivity which triggers due to multiple drugs such as antibiotics, anti-inflammatory, anti-convulsants which occur in 2,2 % of admitted patients. Its importance is related in the high mortality that can achieve 30 %. A case of a 5 year old boy with antecedents of diagnosed epilepsy, treated with carbamazepine, who short time after starting the treatment had fever for 11 days. Posteriorly cutaneous erythematous pruritic maculopapular skin lesions appeared. He was admitted with the diagnosis of prolonged febrile syndrome. Laboratory test showed eosinophilia, elevation of liver tests and C-reactive protein. A syndrome of drug sensitivity was considered induced by carbamazepine, after the result of skin biopsy anti-comicial is suspended thus improving the condition, with normalization of eosinophils and liver function. The patient progressed without fever and good general condition. The case is presented due to the low prevalence of this syndrome in the University Pediatric Hospital Paquito González Cueto. Cienfuegos.

BACKGROUND: Allergic bronchopulmonary aspergillosis is a disease resulting from a hypersensitivity reaction to the Aspergillus fungus by invading the airway. It is characterized clinically by dyspnea, wheezing, fever, malaise and brown or black expectoration, and by poor clinical response to the usual treatment prescribed to treat exacerbations in patients with chronic lung disease. Aspergillosis is considered the fourth most important fungal disease in Mexico; however, its role in asthmatic patients in our country is unknown. CLINICAL CASE: A 60-year-old female patient, a health worker, with asthma of difficult control and a severe asthma attack; the diagnosis of allergic bronchopulmonary aspergillosis and its subsequent treatment were demonstrated. CONCLUSIONS: Allergic bronchopulmonary aspergillosis is a disease difficult to diagnose in atopic, immunosuppressed or cystic fibrosis patients that all physicians treating patients who do not respond to standard treatment should suspect. [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Colombiana is the property of Acta Medica Colombiana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Gastroenterología del Perú is the property of Sociedad de Gastroenterologia del Peru and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)