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Long-term prognosis and its associated predictive factors in patients with eosinophilic gastroenteritis 被引量:3
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作者 Kai-Wen Li Ge-Chong Ruan +8 位作者 Shuang Liu Tian-Ming Xu Ye Ma Wei-Xun Zhou Wei Liu Peng-Yu Zhao Zhi-Rong Du Ji Li Jing-Nan Li 《World Journal of Gastroenterology》 SCIE CAS 2024年第2期146-157,共12页
BACKGROUND Eosinophilic gastroenteritis(EGE)is a chronic recurrent disease with abnormal eosinophilic infiltration in the gastrointestinal tract.Glucocorticoids remain the most common treatment method.However,disease ... BACKGROUND Eosinophilic gastroenteritis(EGE)is a chronic recurrent disease with abnormal eosinophilic infiltration in the gastrointestinal tract.Glucocorticoids remain the most common treatment method.However,disease relapse and glucocorticoid dependence remain notable problems.To date,few studies have illuminated the prognosis of EGE and risk factors for disease relapse.AIM To describe the clinical characteristics of EGE and possible predictive factors for disease relapse based on long-term follow-up.METHODS This was a retrospective cohort study of 55 patients diagnosed with EGE admitted to one medical center between 2013 and 2022.Clinical records were collected and analyzed.Kaplan-Meier curves and log-rank tests were conducted to reveal the risk factors for long-term relapse-free survival(RFS).RESULTS EGE showed a median onset age of 38 years and a slight female predominance(56.4%).The main clinical symptoms were abdominal pain(89.1%),diarrhea(61.8%),nausea(52.7%),distension(49.1%)and vomiting(47.3%).Forty-three(78.2%)patients received glucocorticoid treatment,and compared with patients without glucocorticoid treatments,they were more likely to have elevated serum immunoglobin E(IgE)(86.8%vs 50.0%,P=0.022)and descending duodenal involvement(62.8%vs 27.3%,P=0.046)at diagnosis.With a median follow-up of 67 mo,all patients survived,and 56.4%had at least one relapse.Six variables at baseline might have been associated with the overall RFS rate,including age at diagnosis<40 years[hazard ratio(HR)2.0408,95%confidence interval(CI):1.0082–4.1312,P=0.044],body mass index(BMI)>24 kg/m^(2)(HR 0.3922,95%CI:0.1916-0.8027,P=0.014),disease duration from symptom onset to diagnosis>3.5 mo(HR 2.4725,95%CI:1.220-5.0110,P=0.011),vomiting(HR 3.1259,95%CI:1.5246-6.4093,P=0.001),total serum IgE>300 KU/L at diagnosis(HR 0.2773,95%CI:0.1204-0.6384,P=0.022)and glucocorticoid treatment(HR 6.1434,95%CI:2.8446-13.2676,P=0.003).CONCLUSION In patients with EGE,younger onset age,longer disease course,vomiting and glucocorticoid treatment were risk factors for disease relapse,whereas higher BMI and total IgE level at baseline were protective. 展开更多
关键词 eosinophilic gastroenteritis PROGNOSIS RELAPSE GLUCOCORTICOID Glucocorticoid dependence
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Animal models of eosinophilic esophagitis,review and perspectives
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作者 Dong Li Yujia Wei +1 位作者 Jing Wang Bo Wang 《Animal Models and Experimental Medicine》 CAS CSCD 2024年第2期127-135,共9页
Eosinophilic oesophagitis(EoE)is an allergen/immune-mediated chronic esophageal disease characterized by esophageal mucosal eosinophilic infiltration and esophageal dysfunction.Although the disease was originally attr... Eosinophilic oesophagitis(EoE)is an allergen/immune-mediated chronic esophageal disease characterized by esophageal mucosal eosinophilic infiltration and esophageal dysfunction.Although the disease was originally attributed to a delayed allergic reaction to allergens and a Th2-type immune response,the exact pathogenesis is complex,and the efficacy of existing treatments is unsatisfactory.Therefore,the study of the pathophysiological process of EOE has received increasing attention.Animal models have been used extensively to study the molecular mechanism of EOE pathogenesis and also provide a preclinical platform for human clinical intervention studies of novel therapeutic agents.To maximize the use of existing animal models of EOE,it is important to understand the advantages or limitations of each modeling approach.This paper systematically describes the selection of experimental animals,types of allergens,and methods of sensitization and excitation during the preparation of animal models of EoE.It also discusses the utility and shortcomings of each model with the aim of providing the latest perspectives on EoE models and leading to better choices of animal models. 展开更多
关键词 ANAPHYLAXIS disease models ANIMAL eosinophilic esophagitis METHODS
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Chest CT quantitative parameters in patients with acute exacerbation of chronic obstructive pulmonary disease:Correlations with blood eosinophil level
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作者 YANG Lu SHENG Yadan +7 位作者 YANG Kai HE Liyu GU Huihui SUN Guoqing CHEN Weiting ZHU Bingjie CHEN Yanrong JIN Chenwang 《中国医学影像技术》 CSCD 北大核心 2024年第8期1189-1193,共5页
Objective To observe the correlations of chest CT quantitative parameters in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with blood eosinophil(EOS)level.Methods Chest CT data of 16... Objective To observe the correlations of chest CT quantitative parameters in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with blood eosinophil(EOS)level.Methods Chest CT data of 162 AECOPD patients with elevated eosinophils were retrospectively analyzed.The patients were divided into low EOS group(n=105)and high EOS group(n=57)according to the absolute counting of blood EOS.The quantitative CT parameters,including the number of whole lung bronchi and the volume of blood vessels,low-attenuation area percentage(LAA%)of whole lung,of left/right lung and each lobe of lung,as well as the luminal diameter(LD),wall thickness(WT),wall area(WA)and WA percentage of total bronchial cross-section(WA%)of grade 3 to 8 bronchi were compared between groups.Spearman correlations were performed to analyze the correlations of quantitative CT parameters with blood EOS level.Results LAA%of the whole lung,of the left/right lung and each lobe of lung,as well as of the upper lobe of right lung LD grade 4,middle lobe of right lung WT grade 5,upper lobe of right lung WA grade 4,middle lobe of right lung WA grade 5 and lower lobe of left lung WA grade 3 in low EOS group were all higher than those in high EOS group(all P<0.05).Except for the upper lobe of right lung LD grade 4,the above quantitative CT indexes being significant different between groups were all weakly and negatively correlated with blood EOS level(r=-0.335 to-0.164,all P<0.05).Conclusion Chest CT quantitative parameters of AECOPD patients were correlated with blood EOS level,among which LAA%,a part of WT and WA were all weakly negatively correlated with blood EOS level. 展开更多
关键词 pulmonary disease chronic obstructive eosinophilS tomography X-ray computed
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Acute Eosinophilic Pneumonia (AEP) Due to Daptomycin: Is Autoimmunity a Clinico-Pathophysiologic Bridge to AEP?
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作者 Shadee Tajik Sami Akram 《International Journal of Clinical Medicine》 CAS 2024年第8期365-374,共10页
Daptomycin induced acute eosinophilic pneumonia is a rare and potentially life threatening condition characterized by rapid respiratory failure, pulmonary infiltrates and eosinophilia. Risk factors for acute eosinophi... Daptomycin induced acute eosinophilic pneumonia is a rare and potentially life threatening condition characterized by rapid respiratory failure, pulmonary infiltrates and eosinophilia. Risk factors for acute eosinophilic pneumonia include smoking, environmental irritants or inhalants and certain medications such as Daptomycin [1]. In this review of literature, we aim to explore the potential triggers for developing acute eosinophilic pneumonia in patients exposed to Daptomycin. The exact immune mechanism for daptomycin induced AEP is unknown, however the current proposed mechanism describes a T helper 2 lymphocyte response to inactivated daptomycin in the pulmonary surfactant, which leads to eosinophilia. Disordered T regulatory cell function is seen in patients with certain cancers, allergies and autoimmune conditions. We propose that patients with these underlying risk factors may be at increased risk of developing AEP after becoming exposed to Daptomycin. Understanding potential risk factors is crucial for health care workers as it allows them to identify susceptible populations, explore preventative measures and treat accordingly. 展开更多
关键词 DAPTOMYCIN Acute eosinophilic Pneumonitis Daptomycin Induced Acute eosinophilic Pneumonia Drug Induced Pneumonia eosinophilic Pneumonia
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Eosinophilic solid and cystic renal cell carcinoma with aggressive behavior:Two case reports
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作者 Hui-Hui Cao Hong Li +2 位作者 Xiao-Hong Guo Zhi-Xing Cao Bo-Hui Zhang 《World Journal of Clinical Cases》 SCIE 2024年第22期5124-5130,共7页
BACKGROUND Eosinophilic solid and cystic(ESC)renal cell carcinoma(RCC),a unique and emerging subtype of RCC,has an indolent nature;in some rare instances,it may exhibit metastatic potential.Current cases are inadequat... BACKGROUND Eosinophilic solid and cystic(ESC)renal cell carcinoma(RCC),a unique and emerging subtype of RCC,has an indolent nature;in some rare instances,it may exhibit metastatic potential.Current cases are inadequate to precisely predict the clinical outcome of ESC RCC and determine treatment choices.CASE SUMMARY Herein,we report two patients with ESC RCC.Patient 1 was a young woman with classical pathological characteristics.Patient 2 was a 52-year-old man with multifocal metastases,involving the pulmonary hilar and mediastinal lymph nodes,liver,brain,mesosternum,vertebra,rib,femur,and symphysis pubis.Awareness of ESC RCC,along with its characteristic architecture and immunophenotype,would contribute to making a definitive diagnosis,even on core biopsy samples.CONCLUSION The discovery of ESC RCC molecular signatures may provide new therapeutic strategies in the future. 展开更多
关键词 eosinophilic solid and cystic renal cell carcinoma Solid and cystic growth pattern CK20 TSC1 mutations TSC2 mutations Case report
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Human Eosinophil Cell Manipulation by Optical Tweezers
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作者 Pavel Yale Jean Michel Edoukoua Konin +2 位作者 Abadê Ange-Boris N’guessan Michel Abaka Kouacou Jérémie T. Zoueu 《Open Journal of Biophysics》 2024年第3期330-338,共9页
In this work, lateral deformation of human eosinophil cell during the lateral indentation by an optically trapped microbead of diameter 4.5 µm is studied. The images were captured using a CCD camera and the Boltz... In this work, lateral deformation of human eosinophil cell during the lateral indentation by an optically trapped microbead of diameter 4.5 µm is studied. The images were captured using a CCD camera and the Boltzmann statistics method was used for force calibration. Using the Hertz model, we calculated and compared the elastic moduli resulting from the lateral force, showing that the differences are important and the force should be considered. Besides the lateral component, the setup also allows us to examine the lateral cell-bead interaction. The mean values of the properties obtained, in particular the elastic stiffness and the shear stiffness, were Eh = (37.76 ± 2.85) µN/m and Gh = (12.57 ± 0.32) µN/m. These results show that the lateral indentation can therefore be used as a routine method for cell study, because it enabled us to manipulate the cell without contact with the laser. 展开更多
关键词 Optical Tweezers Human eosinophil Cell INDENTATION Shear Stiffness
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Evolving strategies: Enhancements in managing eosinophilic esophagitis in pediatric patients
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作者 Ahmed Elghoudi Doaa Zourob +4 位作者 Eman Al Atrash Fatima Alshamsi Manal Alkatheeri Hassib Narchi Rana Bitar 《World Journal of Clinical Pediatrics》 2024年第1期14-22,共9页
Eosinophilic esophagitis is a newly recognized disease first described about 50 years ago.The definition,diagnosis,and management have evolved with new published consensus guidelines and newly approved treatment avail... Eosinophilic esophagitis is a newly recognized disease first described about 50 years ago.The definition,diagnosis,and management have evolved with new published consensus guidelines and newly approved treatment available to pediatricians,enabling a better understanding of this disease and more targeted treatment for patients.We describe the definition,presentation,and diagnosis of eosinophilic esophagitis including management,challenges,and future directions in children.The definition,diagnosis,and management of eosinophilic esophagitis have evolved over the last 50 years.Consensus guidelines and newly approved biologic treatment have enabled pediatricians to better understand this disease and allow for more targeted treatment for patients.We describe the definition,presentation,diagnosis,management,and treatment in addition to the challenges and future directions of eosinophilic esophagitis management in children. 展开更多
关键词 eosinophilic esophagitis ESOPHAGITIS Gastroesophageal reflux disease Food allergy DYSPHAGIA
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Clinical Research Progress of Peripheral Blood Eosinophils in Chronic Obstructive Pulmonary Disease
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作者 Chunxi Li 《Journal of Clinical and Nursing Research》 2024年第6期189-194,共6页
Chronic obstructive pulmonary disease(COPD)accounts for one of the major health and economic burdens worldwide.As a heterogeneous disease,the underlying inflammatory pattern of COPD differs from the previously thought... Chronic obstructive pulmonary disease(COPD)accounts for one of the major health and economic burdens worldwide.As a heterogeneous disease,the underlying inflammatory pattern of COPD differs from the previously thought neutrophil-dominated inflammation,with eosinophilic inflammation occupying approximately one third of stable COPD.Although the eosinophil(EOS)threshold associated with clinical relevance in patients with COPD is currently debated,eosinophil count can be used as a biomarker to guide treatment and to assess the risk of acute exacerbations of COPD,the efficacy of inhaled corticosteroids,and clinical outcomes.The purpose of this review is to describe the biological characteristics of eosinophils and the related research progress as clinical biomarkers. 展开更多
关键词 Chronic obstructive pulmonary disease eosinophilS Biomarkers
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Eosinophilic fasciitis difficult to differentiate from scleroderma:A case report 被引量:1
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作者 Tian-Yi Lan Zi-Han Wang +6 位作者 Wei-Ping Kong Jin-Ping Wang Nan Zhang Di-Er Jin Jing Luo Qing-Wen Tao Ze-Ran Yan 《World Journal of Clinical Cases》 SCIE 2023年第13期3092-3098,共7页
BACKGROUND Eosinophilic fasciitis(EF)is a rare connective tissue disease that can cause swelling and sclerosis of the extremities,and special attention is needed to differentiate EF from systemic sclerosis.Misdiagnosi... BACKGROUND Eosinophilic fasciitis(EF)is a rare connective tissue disease that can cause swelling and sclerosis of the extremities,and special attention is needed to differentiate EF from systemic sclerosis.Misdiagnosis or omission markedly delays treatment of EF,and severe skin sclerosis in advanced stages can cause joint contracture and tendon retraction,worsening the patient's prognosis and quality of life.CASE SUMMARY We report a case of EF in a young woman diagnosed by tissue biopsy,confirming the difficulty of differential diagnosis with scleroderma.CONCLUSION Focusing on skin manifestations,completing tissue biopsy and radiography can help diagnose EF effectively.Clinicians should enhance their understanding of the differences between EF and scleroderma,and early diagnosis and standardized treatment can improve the prognosis of patients with EF. 展开更多
关键词 eosinophilic fasciitis SCLERODERMA BIOPSY DIAGNOSE Prognosis Case report
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Eosinophilic enteritis requiring differentiation from chronic enteropathy associated with SLCO2A1 gene:A case report 被引量:1
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作者 Kantaro Kimura Keisuke Jimbo +5 位作者 Nobuyasu Arai Masamichi Sato Mitsuyoshi Suzuki Takahiro Kudo Tomonori Yano Toshiaki Shimizu 《World Journal of Gastroenterology》 SCIE CAS 2023年第11期1757-1764,共8页
BACKGROUND Eosinophilic gastrointestinal disease(EGID)is a disorder characterized by infiltration of eosinophils causing mucosal damage and dysfunction of the gastrointestinal tract.The endoscopic findings of eosinoph... BACKGROUND Eosinophilic gastrointestinal disease(EGID)is a disorder characterized by infiltration of eosinophils causing mucosal damage and dysfunction of the gastrointestinal tract.The endoscopic findings of eosinophilic enteritis(EoN),an EGID variant,are nonspecific and occasionally difficult to diagnose.In contrast,chronic enteropathy associated with SLCO2A1(CEAS)is a chronic persistent small intestinal disorder characterized by endoscopic findings such as multiple oblique and circular ulcers.CASE SUMMARY We report the case of a 10-year-old boy who had suffered abdominal pain and fatigue for the preceding 6 mo.He was referred to our institute for investigation of suspected gastrointestinal bleeding because of severe anemia with hypoproteinemia and positive fecal human hemoglobin.The upper and lower gastrointestinal endoscopic findings were normal;however,double-balloon small bowel endoscopy showed multiple oblique and circular ulcers with discrete margins and mild constriction of the intestinal lumen in the ileum.The findings were highly consistent with CEAS,but urine prostaglandin metabolites were within normal limits,and no previously reported mutations in the SLCO2A1 gene were identified.Histological evaluation demonstrated moderate to severe eosinophilic infiltration localized to the small intestine suggesting a diagnosis of EoN.Clinical remission was maintained with montelukast and a partial elemental diet,but emergent surgery for bowel obstruction due to small intestinal stenosis was performed two years after the initial treatment.CONCLUSION EoN should be considered in the differential diagnosis of CEAS-like small intestinal ulcerative lesions and normal urinary prostaglandin metabolite levels. 展开更多
关键词 Anemia Chronic enteropathy associated with SLCO2A1 Double-balloon endoscopy eosinophilic gastrointestinal disease HYPOPROTEINEMIA Case report
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Development of Henoch-Schoenlein purpura in a child with idiopathic hypereosinophilia syndrome with multiple thrombotic onset: A case report
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作者 Yan-Yan Xu Xiao-Bi Huang +4 位作者 Yun-Gong Wang Li-Yun Zheng Min Li Yu Dai Sheng Zhao 《World Journal of Clinical Cases》 SCIE 2023年第4期952-961,共10页
BACKGROUND The incidence of pulmonary embolism(PE) in children is low, but its mortality is high. Hypereosinophilic syndrome(HES) is a group of diseases caused by an abnormal increase in eosinophilic granulocytes resu... BACKGROUND The incidence of pulmonary embolism(PE) in children is low, but its mortality is high. Hypereosinophilic syndrome(HES) is a group of diseases caused by an abnormal increase in eosinophilic granulocytes resulting in multiple-organ dysfunction. The urgent event of thromboembolism in the pulmonary region provoked by eosinophils in idiopathic HES(IHES) is relatively unusual. This article reports a case of IHES with multiple PEs and left leg venous thrombosis as the first manifestation. One month later, the patient developed Henoch-Schonlein purpura(HSP), which is very rare.CASE SUMMARY We report the case of a 12-year-old boy who was admitted to the hospital with dyspnea, left leg pain, and aggravation. He had bilateral PE and left leg venous embolism with mild eosinophilia. Low-molecular-weight heparin and urokinase were given. At the same time, the interventional department was contacted about filter implantation, followed by urokinase thrombolysis. The left leg thrombus was aspirated under ultrasound guidance. He was discharged from the hospital on rivaroxaban. One month later, he developed a rash on both legs and ankle pain consistent with HSP, with severe eosinophilia and motor and sensory disturbances. The patient was diagnosed with IHES with multiple embolisms complicated by HSP after excluding other causes of the eosinophil elevation. After glucocorticoid treatment, the symptoms were relieved, but the patient later developed purpura nephritis.CONCLUSION We report a rare and life-threatening case of IHES with multiple embolisms associated with HSP.A mild elevation of eosinophils early in the disease leads to difficulties in diagnosis and delayed treatment. 展开更多
关键词 eosinophil Hypereosinophilic syndrome Henoch-Schoenlein purpura THROMBOSIS Case report
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Diagnostic role of fractional exhaled nitric oxide in pediatric eosinophilic esophagitis, relationship with gastric and duodenal eosinophils
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作者 Panamdeep Kaur Rachel Chevalier +3 位作者 Craig Friesen Jamie Ryan Ashley Sherman Stephanie Page 《World Journal of Gastrointestinal Endoscopy》 2023年第5期407-419,共13页
BACKGROUND Eosinophilic esophagitis(EoE)is an eosinophilic-predominant inflammation of the esophagus diagnosed by upper endoscopy and biopsies.A non-invasive and cost-effective alternative for management of EoE is bei... BACKGROUND Eosinophilic esophagitis(EoE)is an eosinophilic-predominant inflammation of the esophagus diagnosed by upper endoscopy and biopsies.A non-invasive and cost-effective alternative for management of EoE is being researched.Previous studies assessing utility of fractional exhaled nitric oxide(FeNO)in EoE were low powered.None investigated the contribution of eosinophilic inflammation of the stomach and duodenum to FeNO.AIM To assess the utility of FeNO as a non-invasive biomarker of esophageal eosinophilic inflammation for monitoring disease activity.METHODS Patients aged 6-21 years undergoing scheduled upper endoscopy with biopsy for suspected EoE were recruited in our observational study.Patients on steroids and with persistent asthma requiring daily controller medication were excluded.FeNO measurements were obtained in duplicate using a chemiluminescence nitric oxide analyzer(NIOX MINO,Aerocrine,Inc.;Stockholm,Sweden)prior to endoscopy.Based on the esophageal peak eosinophil count(PEC)/high power field on biopsy,patients were classified as EoE(PEC≥15)or control(PEC≤14).Mean FeNO levels were correlated with presence or absence of EoE,eosinophil counts on esophageal biopsy,and abnormal downstream eosinophilia in the stomach(PEC≥10)and duodenum(PEC≥20).Wilcoxon rank-sum test,Spearman correlation,and logistic regression were used for analysis.P value<0.05 was considered significant.RESULTS We recruited a total of 134 patients,of which 45 were diagnosed with EoE by histopathology.The median interquartile range FeNO level was 17 parts per billion(11-37,range:7-81)in the EoE group and 12 parts per billion(8-19,range:5-71)in the control group.After adjusting for atopic diseases,EoE patients had significantly higher FeNO levels as compared to patients without EoE(Z=3.33,P<0.001).A weak yet statistically significant positive association was found between the number of esophageal eosinophils and FeNO levels(r=0.30,P<0.005).On subgroup analysis within the EoE cohort,higher FeNO levels were noted in patients with abnormal gastric(n=23,18 vs 15)and duodenal eosinophilia(n=28,21 vs 14);however,the difference was not statistically significant.CONCLUSION After ruling out atopy as possible confounder,we found significantly higher FeNO levels in the EoE cohort than in the control group. 展开更多
关键词 Nitric oxide Fractional exhaled nitric oxide eosinophilic esophagitis ESOPHAGUS PEDIATRIC GASTROENTEROLOGY
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Posterior pedicle screw fixation combined with local steroid injections for treating axial eosinophilic granulomas and atlantoaxial dislocation:A case report
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作者 Cheng-Quan Tu Zhi-Da Chen +3 位作者 Xiao-Tao Yao Yuan-Jie Jiang Bi-Fang Zhang Bin Lin 《World Journal of Clinical Cases》 SCIE 2023年第20期4944-4955,共12页
BACKGROUND Eosinophilic granuloma(EG)is a proliferative condition that affects the cells of bone tissue.There are no specific clinical signs or imaging manifestations in the early stages of the disease,making it simpl... BACKGROUND Eosinophilic granuloma(EG)is a proliferative condition that affects the cells of bone tissue.There are no specific clinical signs or imaging manifestations in the early stages of the disease,making it simple to overlook and misdiagnose.Because of the disease's rarity,there is presently no standardized treatment principle.There are few accounts of such occurrences affecting the axis among children.We discovered a case of a child whose EG resulted in atlantoaxial joint dislocation and destruction of the axial bone.CASE SUMMARY After having pharyngeal discomfort for more than six months without a clear explanation,a 6-year-old boy was brought to our hospital.Following a careful evaluation,the pathology indicated a strong likelihood of an axial EG.Ultimately,we decided to treat the boy with posterior pedicle screw fixation and local steroid injections.CONCLUSION EGs of the upper cervical spine are quite uncommon in children,and they are exceedingly easy to overlook or misdiagnose.Posterior pedicle screw fixation and local steroid injections are effective treatments for patients with axial EGs affecting the atlantoaxial junction. 展开更多
关键词 eosinophilic granuloma Atlantoaxial joint dislocation Local steroid injections Children OSTEOPATHY Posterior surgery Case report
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Imipenem/cilastatin-induced acute eosinophilic pneumonia:A case report
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作者 Gautam Jesrani Samiksha Gupta +2 位作者 Amtoj Singh Lamba Shreya Arora Monica Gupta 《Journal of Acute Disease》 2023年第6期250-253,共4页
Rationale:Acute eosinophilic pneumonia(AEP)is an acute pulmonary illness caused by eosinophilic infiltration of the lung parenchyma.It can happen after using drugs such as daptomycin and minocycline.AEP induced by imi... Rationale:Acute eosinophilic pneumonia(AEP)is an acute pulmonary illness caused by eosinophilic infiltration of the lung parenchyma.It can happen after using drugs such as daptomycin and minocycline.AEP induced by imipenem/cilastatin is a rare condition.Patient’s Concern:A 45-year-old male patient,who previously suffered from a urinary tract infection and treated with imipenem/cilastatin antibiotic,was presented to us with acute respiratory distress,soon after the initiation of the antibiotic.Computed tomography identified pulmonary infiltrates in the upper and middle lung fields and eosinophils were found to account for 36%of differential count of the broncho-alveolar lavage fluid.He also developed peripheral eosinophilia as the disease progressed.Diagnosis:AEP,secondary to imipenem/cilastatin therapy.Interventions:Steroid therapy was administered and imipenem/cilastatin antibiotic was discontinued.Outcomes:The patient improved completely following the therapy and had clear lung fields on follow-up.Lessons:Imipenem/cilastatin is an uncommon cause of AEP and requires close monitoring during therapy. 展开更多
关键词 Acute eosinophilic pneumonia Broncho-alveolar lavage Imipenem/cilastatin Pulmonary infiltrate Peripheral eosinophilia
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血清YKL⁃40与气道炎性因子在婴幼儿喘息中的表达及临床意义 被引量:1
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作者 王淑玉 郑一博 +4 位作者 杨蕾 李矢云 马晓琳 刘凡 张伟 《临床误诊误治》 CAS 2024年第4期52-56,共5页
目的探讨血清YKL-40及气道炎性因子白细胞介素(IL)-5和IL-8在婴幼儿喘息中的表达情况及临床意义。方法选择2021年6月—2023年5月收治的喘息急性发作(急性期)患儿70例,其中初次喘息发作32例,反复喘息38例。经治疗恢复期34例。另选取同期... 目的探讨血清YKL-40及气道炎性因子白细胞介素(IL)-5和IL-8在婴幼儿喘息中的表达情况及临床意义。方法选择2021年6月—2023年5月收治的喘息急性发作(急性期)患儿70例,其中初次喘息发作32例,反复喘息38例。经治疗恢复期34例。另选取同期体检健康婴幼儿22例为健康对照组。反复喘息患儿依据哮喘预测指数(API)分为阳性组23例和阴性组15例。检测上述各组血清YKL-40、IL-5和IL-8水平,分析YKL-40与IL-5、IL-8、外周血中性粒细胞及嗜酸粒细胞的相关性。结果喘息急性期患儿血清YKL-40、IL-5、IL-8水平均高于喘息恢复期和健康对照组(P<0.01)。反复喘息组血清YKL-40和IL-8水平均高于初次喘息组(P<0.01)。API阳性组与API阴性组血清YKL-40、IL-5和IL-8水平比较差异无统计学意义(P>0.05)。血清YKL-40与IL-8呈显著正相关(r=0.926,P<0.001),但与IL-5、外周血嗜酸粒细胞绝对值、中性粒细胞绝对值均无相关性(P>0.05)。结论血清YKL-40、IL-5和IL-8参与婴幼儿喘息急性气道炎症过程,YKL-40可能与中性粒细胞炎症有关。YKL-40水平增高可能是婴幼儿喘息发作和反复喘息的危险因素,但与API无关。 展开更多
关键词 喘息 哮喘 YKL-40 白细胞介素-5 白细胞介素-8 嗜酸粒细胞 中性粒细胞 婴幼儿
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Adult eosinophilic esophagitis and advances in its treatment
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作者 Martina Grando Silvia De Pauli +2 位作者 Giovanni Miotti Massimiliano Balbi Marco Zeppieri 《World Journal of Methodology》 2023年第3期59-66,共8页
Eosinophilic esophagitis(EoE)is a chronic eosinophil inflammation that seems to be T helper type 2 antigen-driven.The disease is one of several eosinophilic gastrointestinal disorders in which there appears to be infl... Eosinophilic esophagitis(EoE)is a chronic eosinophil inflammation that seems to be T helper type 2 antigen-driven.The disease is one of several eosinophilic gastrointestinal disorders in which there appears to be inflammation of the gastrointestinal tract without any apparent underlying causes.Differential diagnosis needs to be made with gastroesophageal reflux,which is characterized by chronic inflammation due to gastric refluxate from disorders related to motility.EoE,however,is considered a chronic allergic inflammatory disorder related to destructive tissue remodeling.There seems to be a higher prevalence of EoE in Western countries.It is typically found in atopic male individuals.Physiopathological risk factors include atopy,environmental factors,esophageal epithelial barrier dysfunctions,etc.EoE can cause several symptoms that include retrosternal burning sensation,dysphagia,food impaction,chronic reflux symptoms,nausea,and vomiting.Early diagnosis,which requires a biopsy to assess for esophageal inflammation,is essential for proper treatment.The aim of our brief overview is to summarize the current literature regarding the characteristics,diagnosis,complications,mechanisms of pathology,clinical features,influence of comorbidities,and treatment in patients with EoE. 展开更多
关键词 eosinophilic esophagitis Gastroesophageal reflux Chronic allergic inflammatory disorder eosinophil inflammation T helper 2
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Eosinophil disorders:an update on diagnosis and management
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作者 Chuan-Yi M.Lu 《Oncology and Translational Medicine》 2023年第5期193-198,共6页
Eosinophilia can be seen in almost all medical subspecialty patients.Delay in diagnostic workup and treatment is associated with significant morbidity and mortality.Clinical vigilance and timely referral for diagnosti... Eosinophilia can be seen in almost all medical subspecialty patients.Delay in diagnostic workup and treatment is associated with significant morbidity and mortality.Clinical vigilance and timely referral for diagnostic evaluation are critical.Causes of hypereosinophilia(HE)are diverse and can be grouped under 3 categories:primary(neoplastic),secondary(reactive),and idiopathic.Advances in molecular genetic diagnostics have led to elucidation of the genetic basis formany neoplastic hypereosinophilic disorders.One commonmolecular feature is formation of a fusion gene,resulting in the expression of an aberrantly activated tyrosine kinase(TK).TheWorld Health Organization endorsed a biologically oriented classification scheme and created a new major disease category,namely,myeloid/lymphoid neoplasms with eosinophilia and tyrosine kinase gene fusions.Rearrangement of other TK genes and activating somatic mutation(s)in TK genes have also been reported in eosinophilic neoplasms.Diagnostic evaluation of HE involves a combination of clinical,histopathologic,and immunophenotypic analyses,as well as molecular genetic testing,including next-generation sequencing–based mutation panels.The management of primary HE is largely guided by the underlying molecular genetic abnormalities.Good knowledge of recent advances in HE is necessary to ensure timely and accurate diagnosis and to help optimize patient care. 展开更多
关键词 eosinophil eosinophilIA Hematological malignancy Molecular genetics Precision diagnostics Targeted therapy Tyrosine kinase
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呼出气一氧化氮、肺泡一氧化氮和嗜酸性粒细胞对3~6岁儿童呼吸系统疾病的鉴别诊断价值 被引量:1
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作者 李阳 张宇翔 张蓉芳 《实用临床医药杂志》 CAS 2024年第6期74-78,共5页
目的探讨呼出气一氧化氮(FeNO)、肺泡一氧化氮(CaNO)和嗜酸性粒细胞(EOS)在甘肃省兰州市3~6岁儿童呼吸系统疾病鉴别诊断中的应用价值。方法选取确诊哮喘或过敏性鼻炎或下呼吸道感染的360例3~6岁儿童作为研究对象,采用斯皮尔曼秩相关系... 目的探讨呼出气一氧化氮(FeNO)、肺泡一氧化氮(CaNO)和嗜酸性粒细胞(EOS)在甘肃省兰州市3~6岁儿童呼吸系统疾病鉴别诊断中的应用价值。方法选取确诊哮喘或过敏性鼻炎或下呼吸道感染的360例3~6岁儿童作为研究对象,采用斯皮尔曼秩相关系数评估FeNO、CaNO、EOS的相关性,通过随机森林模型、受试者工作特征(ROC)曲线、多因素逻辑回归分析评估FeNO、CaNO和EOS对3种疾病的鉴别诊断价值。结果哮喘患儿的FeNO、CaNO中位数高于其他疾病患儿,过敏性鼻炎患儿的EOS中位数最低,下呼吸道感染患儿的FeNO、CaNO中位数最低。相关性分析结果显示,FeNO与CaNO呈正相关(r=0.59,P<0.05),FeNO与EOS呈负相关(r=-0.61,P<0.05),CaNO与EOS呈负相关(r=-0.63,P<0.05)。随机森林模型显示,FeNO在疾病分类中的重要性最高。ROC曲线分析结果显示,3种疾病中,FeNO、CaNO、EOS对下呼吸道感染的诊断效能均最高(曲线下面积分别为0.86、0.91、1.00)。多因素逻辑回归模型诊断哮喘的曲线下面积为0.96,灵敏度为0.902,特异度为0.881。结论FeNO、CaNO和EOS在鉴别诊断兰州地区3~6岁儿童哮喘、过敏性鼻炎、下呼吸道感染方面展现出较好的潜力,且基于三者构建的多因素逻辑回归模型可有效提升对哮喘的诊断准确性。 展开更多
关键词 呼出气一氧化氮 肺泡一氧化氮 嗜酸性粒细胞 儿童 哮喘 过敏性鼻炎 下呼吸道感染
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非嗜酸性粒细胞哮喘诊治进展
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作者 张心悦 邵子建 +4 位作者 练康 吴德美 袁斌 吴芳 唐兰芳 《重庆医科大学学报》 CAS CSCD 北大核心 2024年第1期1-7,共7页
哮喘是全球最常见的慢性呼吸系统疾病之一,非嗜酸性粒细胞哮喘(non-eosinophilic asthma,NEA)是哮喘的一种特殊表型,其气道炎症的特征是细胞浸润以中性粒细胞为主,缺乏嗜酸性粒细胞。NEA发病与环境及宿主因素均有关,例如职业暴露、环境... 哮喘是全球最常见的慢性呼吸系统疾病之一,非嗜酸性粒细胞哮喘(non-eosinophilic asthma,NEA)是哮喘的一种特殊表型,其气道炎症的特征是细胞浸润以中性粒细胞为主,缺乏嗜酸性粒细胞。NEA发病与环境及宿主因素均有关,例如职业暴露、环境污染、吸烟、感染和肥胖,上述风险因素单独或联合作用可以激活特定的细胞和分子途径,导致NEA发生。NEA的临床特征是对标准哮喘治疗的反应不佳,尤其是对吸入性皮质类固醇,导致疾病更严重和难以控制的哮喘。虽然NEA不是最普遍的哮喘表型,但重度哮喘患者中NEA比例高,其重要性不容忽视。本文就近年来NEA的流行病学现状、致病因素、发病机制和治疗现状作一综述。 展开更多
关键词 哮喘 非嗜酸性粒细胞型 诊断 治疗
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老年嗜酸性肉芽肿性多血管炎患者的临床分析
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作者 张隽 李杰 +2 位作者 王晶 华琳 张黎明 《首都医科大学学报》 CAS 北大核心 2024年第3期515-523,共9页
目的分析老年嗜酸性肉芽肿性多血管炎(eosinophilic granulomatosis with polyangiitis,EGPA)患者的临床特征。方法回顾性分析2007年2月至2022年2月首都医科大学附属北京朝阳医院确诊的EGPA患者的临床资料,根据年龄分为老年组(年龄≥60... 目的分析老年嗜酸性肉芽肿性多血管炎(eosinophilic granulomatosis with polyangiitis,EGPA)患者的临床特征。方法回顾性分析2007年2月至2022年2月首都医科大学附属北京朝阳医院确诊的EGPA患者的临床资料,根据年龄分为老年组(年龄≥60岁)和非老年组(年龄<60岁),比较两组患者临床特征的差异并随访预后。结果共纳入101例EGPA患者,其中老年组42例(41.6%),非老年组59例(58.4%)。老年组与非老年组比较,合并高血压病(40.5%vs 16.9%,P=0.008)、血嗜酸性粒细胞>10%(90.5%vs 72.9%,P=0.029)及估算肾小球滤过率(estimated glomerular filtration rate,eGFR)降低[eGFR<80 mL·min^(-1)·(1.73 m^(2))^(-1)](61.9%vs 16.9%,P<0.001)的患者比例更高,老年组红细胞沉降率(erythrocyte sedimentation rate,ESR)[20(10,56.25)mm/h vs 12(5,32.25)mm/h,P=0.028]及肺功能指标残气量/肺总量(residual volume/total lung capacity,RV/TLC)[(48.84±11.43)%vs(41.92±9.06)%,P=0.009]更高。老年组与非老年组相比,心脏受累(73.8%vs 32.2%,P<0.001)、中枢神经系统受累(23.8%vs 5.1%,P=0.006)、周围神经系统病变(83.3%vs 64.4%,P=0.036)、肾脏受累(69.0%vs 47.5%,P=0.031)及五因子评分(five-factor score,FFS)≥2分(61.9%vs 15.3%,P<0.001)的发生率均更高。随访中位时间41(19,59)个月,6例患者死亡,老年组病死率高于非老年组(13.9%vs 1.92%,P=0.032)。结论老年EGPA患者合并高血压病、血嗜酸性粒细胞>10%、eGFR降低、脏器受累及FFS≥2分的患者比例更高,ESR、RV/TLC及病死率更高。临床医生应加强对老年EGPA患者疾病特征的认识,以提高诊断和治疗水平。 展开更多
关键词 嗜酸性肉芽肿性多血管炎 老年患者 临床特征
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