1.Successful Cyclophosphamide Therapy in Recurrent Eosinophilic Colitis Associated with Hypereosinophilic Syndrome.
Ju Hee LEE ; Jin Woo LEE ; Cheol Soon JANG ; Eun Sang KWON ; Hyo Young MIN ; Seok JEONG ; Kye Sook KWON ; Don Haeng LEE ; Hyeon Geun CHO ; Pum Soo KIM ; Hyung Gil KIM ; Yong Woon SHIN ; Young Soo KIM
Yonsei Medical Journal 2002;43(2):267-270
Eosinophilic colitis is a relatively rare complication of hypereosinophilic syndrome which is characterized by abdominal pain and bloody diarrhea and is usually treated with steroids and hydroxyurea. However, no standard regimen exists in cases of intractable disease despite several treatment attempts with Interferon- alpha, cyclosporin, etoposide, and vincristine, etc. We here report a case of a 43-year-old woman with recurrent eosinophilic colitis as a complication of hypereosinophilic syndrome who was successfully treated with cyclophosphamide.
Adult
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Case Report
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Colitis/*complications/*drug therapy/pathology
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Cyclophosphamide/*therapeutic use
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Eosinophilia/*complications/*drug therapy/pathology
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Female
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Human
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Hypereosinophilic Syndrome/*complications
;
Recurrence
2.Cytomegalovirus (CMV) hepatitis: an uncommon complication of CMV reactivation in drug reaction with eosinophilia and systemic symptoms.
Yu Jun WONG ; Karen Jui Lin CHOO ; Jade Xiao Jue SOH ; Chee Kiat TAN
Singapore medical journal 2018;59(1):112-113
Adult
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Cytomegalovirus
;
Cytomegalovirus Infections
;
complications
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Drug Hypersensitivity Syndrome
;
complications
;
virology
;
Eosinophilia
;
complications
;
virology
;
Fatal Outcome
;
Female
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Gout
;
drug therapy
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Hepatitis
;
complications
;
virology
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Humans
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Liver
;
physiopathology
;
Viremia
3.Eosinophilic gastroenteritis associated with food allergy and bronchial asthma.
Hae Sim PARK ; Hak San KIM ; Hee Jin JANG
Journal of Korean Medical Science 1995;10(3):216-219
I n some patients, eosinophilic gastroenteritis(EG) occurs in those with food allergy. We experienced a non-atopic asthmatic who had an EG associated with food allergy to fish and eggs, and blood eosinophilia. A skin prick test and RAST to causative food allergens showed a negative result. A fiber-optic endoscopic biopsy from the gastric mucosa showed an intense eosinophilic infiltration. We could find symptomatic improvement and a disappearance of eosinophilic infiltration in gastric mucosa after complete avoidance from the causative food and oral cortcosteroid. It was suggested that fiber-optic endoscopic biopsy might be needed to identify coexisting EG if an allergic patient with blood eosinophilia complains of severe gastrointestinal symptoms.
Adrenal Cortex Hormones/therapeutic use
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Asthma/*complications/drug therapy
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Case Report
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Endoscopy
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Eosinophilia/*complications
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Food Hypersensitivity/*complications
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Gastric Mucosa/pathology
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Gastroenteritis/*complications/diagnosis/pathology
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Human
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Male
;
Middle Age
4.Strongyloidiasis in a Diabetic Patient Accompanied by Gastrointestinal Stromal Tumor: Cause of Eosinophilia Unresponsive to Steroid Therapy.
Eun Jeong WON ; Jin JEON ; Young Il KOH ; Dong Wook RYANG
The Korean Journal of Parasitology 2015;53(2):223-226
We report here a case of strongyloidiasis in a 72-year-old diabetic patient (woman) accompanied by gastrointestinal stromal tumor receiving imatinib therapy, first diagnosed as hypereosinophilic syndrome and treated with steroids for uncontrolled eosinophilia. She suffered from lower back pain and intermittent abdominal discomfort with nausea and diagnosed with gastrointestinal stromal tumor. After post-operative imatinib treatment eosinophilia persisted, so that steroid therapy was started under an impression of hypereosinophilic syndrome. In spite of 6 months steroid therapy, eosinophilia persisted. Stool examination was performed to rule out intestinal helminth infections. Rhabditoid larvae of Strongyloides stercoralis were detected and the patient was diagnosed as strongyloidiasis. This diagnosis was confirmed again by PCR. The patient was treated with albendazole for 14 days and her abdominal pain and diarrhea improved. This case highlights the need for thorough investigation, including molecular approaches, to test for strongyloidiasis before and during steroid therapies.
Aged
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Albendazole/administration & dosage
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Animals
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Diabetes Mellitus, Type 2/complications
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Eosinophilia/complications/*drug therapy
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Female
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Gastrointestinal Stromal Tumors/complications/*drug therapy
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Humans
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Imatinib Mesylate/*administration & dosage
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Steroids/*administration & dosage
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Strongyloides stercoralis/genetics/isolation & purification/physiology
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Strongyloidiasis/*drug therapy/parasitology
5.Eosinophilic gastroenteritis presenting with duodenal obstruction and ascites.
Kian Chai LIM ; Hsien Khai TAN ; Andrea RAJNAKOVA ; Sudhakar Kundapur VENKATESH
Annals of the Academy of Medicine, Singapore 2011;40(8):379-381
Adult
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Ascites
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diagnosis
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etiology
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Biopsy
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Diagnosis, Differential
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Duodenal Obstruction
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diagnosis
;
etiology
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Endoscopy, Gastrointestinal
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Enteritis
;
complications
;
drug therapy
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Eosinophilia
;
complications
;
drug therapy
;
Gastritis
;
complications
;
drug therapy
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Humans
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Intestinal Mucosa
;
pathology
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Male
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Tomography, X-Ray Computed
6.Hypereosinophilia with Multiple Thromboembolic Cerebral Infarcts and Focal Intracerebral Hemorrhage.
Eun Ju LEE ; Young Jun LEE ; Seung Ro LEE ; Dong Woo PARK ; Hyun Young KIM
Korean Journal of Radiology 2009;10(5):511-514
We report a case of hypereosinophilia causing multiple areas of cerebral infarcts. A 52-year-old Korean man presented with dysarthria and weakness in both arms. A brain MRI revealed multiple acute infarcts in the distal border zone with focal intracerebral hemorrhage, whereas a cerebral angiogram was not remarkable. The eosinophil count was 5,500/microLiter and was accompanied by elevated cardiac enzyme levels. The pattern of cerebral infarcts and laboratory results suggest a thromboembolic infarction associated with hypereosinophilia.
Cerebral Hemorrhage/diagnosis/*etiology
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Cerebral Infarction/diagnosis/*etiology
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Diagnosis, Differential
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Eosinophilia/*complications/drug therapy
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Humans
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Magnetic Resonance Imaging
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Male
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Middle Aged
7.A clinical study of eosinophilic meningoencephalitis caused by angiostrongyliasis.
Xiaotong WANG ; Hanjin HUANG ; Qiqian DONG ; Yan LIN ; Zongmin WANG ; Fangqu LI ; Yukifumi NAWA ; Kentars YOSHIMURA
Chinese Medical Journal 2002;115(9):1312-1315
OBJECTIVETo improve the clinician's awareness of angiostrongyliasis.
METHODSThe clinical and laboratory data as well as the epidemiological information concerning 18 patients with eosinophilic meningoencephalitis caused by Angiostrongylus cantonensis were analyzed.
RESULTSAll patients had a history of eating raw fresh water snail (Ampularium canaliculatus) before the onset of the disease. Incubation period ranged from 1 to 25 days. The major symptoms of the patients had severe headache and pain in the trunk and limbs. Increased eosinophlic count in peripheral blood and cerebrospinal fluid was noted. Tested by enzyme-linked immunoadsorbent assay (ELISA), sera were specifically IgG-antibody positive against Angiostrougylus cantonensis antigen, but were negative against other parasitic antigens such as Paragonimus westermani, Cysticerus, Cellulosae hominis, Echinococcus granulosus and Trichinella spiralis. Abnormal spotty signals were found in 2 cases with brain magnetic resonance imaging. Electroencephalogram (EEG) showed slow alpha rhythm. All the patients were effectively treated with combined administration of albendazole and dexamethazone.
CONCLUSIONSAngiostrongyliasis is one of the common causes leading to eosinophilic meningoencephalitis. To our knowledge, Wenzhou is the first small outbreak site of angiostrongyliasis discovered in Chinese mainland.
Adult ; Albendazole ; administration & dosage ; Angiostrongylus cantonensis ; Animals ; Dexamethasone ; administration & dosage ; Eosinophilia ; etiology ; Female ; Humans ; Male ; Meningoencephalitis ; etiology ; Middle Aged ; Prognosis ; Strongylida Infections ; complications ; drug therapy
8.A case of eosinophilic meningitis caused by cysticercosis of brain.
Chinese Journal of Pediatrics 2003;41(6):438-438
Animals
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Antibodies, Helminth
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blood
;
cerebrospinal fluid
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Child, Preschool
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Eosinophilia
;
cerebrospinal fluid
;
diagnosis
;
etiology
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Female
;
Humans
;
Meningitis
;
cerebrospinal fluid
;
diagnosis
;
etiology
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Neurocysticercosis
;
complications
;
drug therapy
;
parasitology
;
Taenia
;
immunology
9.Eosinophilic Peritonitis in a Patient with Continuous Ambulatory Peritoneal Dialysis (CAPD) .
Se Yong OH ; Hyang KIM ; Jeung Mook KANG ; Sung Ho LIM ; Hyun Duk PARK ; Soo Suk JUNG ; Kyu Beck LEE
The Korean Journal of Internal Medicine 2004;19(2):121-123
Eosinophilic peritonitis is defined as when there are more than 100 eosinophils present per milliliter of peritoneal effluent, of which eosinophils constitute more than 10% of its total WBC count. Most cases occur within the first 4 weeks of peritoneal catheter insertion and they usually have a benign and self-limited course. We report a patient of eosinophilic peritonitis that was successfully resolved without special treatment. An 84-year-old man with end stage renal disease secondary to diabetic nephropathy was admitted for dyspnea and poor oral intake. Allergic history was negative. and physical examination was unremarkable. Complete blood count showed a hemoglobin level of 11.1 g/dL, WBC count was 24, 500/mm3 (neutrophil, 93%; lymphocyte, 5%; monocyte, 2%), platelet count was 216, 000/mm3, serum BUN was 143 mg/dL, Cr was 5.7 mg/dL and albumin was 3.5 g/dL. Creatinine clearance was 5.4 mL/min. Three weeks after peritoneal catheter insertion, he was started on peritoneal dialysis with a 6-hour exchange of 2L 1.5% peritoneal dialysate. After nine days, he developed turbid peritoneal effluents with fever (38.4degrees C), abdominal pain and tenderness. Dialysate WBC count was 180/mm3 (neutrophil, 20%; lymphocyte, 4%; eosinophil, 76% [eosinophil count: 136/mm3]). Cultures of peritoneal fluid showed no growth of aerobic or anaerobic bacteria, or of fungus. Continuous ambulatory peritoneal dialysis (CAPD) was commenced, and he was started on intraperitoneal ceftazidime (1.0 g/day) and cefazolin (1.0 g/day). After two weeksr, the dialysate had cleared up and clinical symptoms were improved. Dialysate WBC count decreased to 8/mm3 and eosinophils were not detected in peritoneal fluid. There was no recurrence of eosinophilic peritonitis on follow-up evaluation, but he died of sepsis and pneumonia fifteen weeks after admission.
Aged, 80 and over
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Anti-Bacterial Agents/therapeutic use
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Cefazolin/therapeutic use
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Ceftazidime/therapeutic use
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Diabetic Nephropathies/complications
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Eosinophilia/drug therapy/*etiology
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Humans
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Kidney Failure, Chronic/etiology/therapy
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Male
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Peritoneal Dialysis, Continuous Ambulatory/*adverse effects
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Peritonitis/drug therapy/*etiology
10.Clinical Features of Eosinophilic Bronchitis.
Jae Hak JOO ; Sang Joon PARK ; Sung Woo PARK ; June Hyuk LEE ; Do Jin KIM ; Soo Taek UH ; Yong Hoon KIM ; Choon Sik PARK
The Korean Journal of Internal Medicine 2002;17(1):31-37
BACKGROUND: Eosinophilic inflammation of the airway is usually associated with airway hyper-responsiveness in bronchial asthma. However, there is a small group of patients which has the eosinophilic inflammation in the bronchial tree with normal spirometry and no evidence of airway hyper-responsiveness, which was named eosinophilic bronchitis. The objectives of this study are 1) to investigate the incidence of eosinophilic bronchitis in the chronic cough syndrome and 2) to evaluate the clinical features and course of eosinophilic bronchitis. METHODS: We evaluated 92 patients who had persistent cough for 3 weeks or longer. In addition to routine diagnostic protocol, we performed differential cell count of sputum. Eosinophilic bronchitis was diagnosed when the patient had normal spirometric values, normal peak expiratory flow variability, no airway hyper-responsiveness and sputum eosinophilia (>3%). RESULTS: The causes of chronic cough were post-nasal drip in 33%, cough variant asthma in 16%, chronic bronchitis in 15% and eosinophilic bronchitis in 12% of the study subjects. Initial eosinophil percentage in the sputum of patients with eosinophilic bronchitis was 26.8+/-6.1% (3.8-63.7%). Treatment with inhaled steroid is related with a subjective improvement of cough severity and a significant decrease of sputum eosinophil percentage (from 29.1+/-8.3% to 7.4+/-3.3%). During the follow-up period, increase in sputum eosinophil percentage with aggravation of symptoms were found. CONCLUSION: Eosinophilic bronchitis is one of the important cause of chronics cough. Assessment of airway inflammation by sputum examination is important in investigating the cause of chronic cough. Cough in eosinophilic bronchitis is effectively controlled by inhaled corticosteroid, but may follow a chronic course.
Adult
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Aged
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Anti-Inflammatory Agents, Steroidal/therapeutic use
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Asthma/complications/epidemiology
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Bronchitis/*complications/diagnosis/drug therapy/epidemiology
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Budesonide/therapeutic use
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Chronic Disease
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Cough/epidemiology/*etiology
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Eosinophilia/*complications/diagnosis/drug therapy/epidemiology
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Female
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Gastroesophageal Reflux/complications/epidemiology
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Human
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Male
;
Middle Age
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Respiratory Function Tests
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Severity of Illness Index
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Sputum/chemistry/immunology