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United European Gastroenterol J 2021 Jun 12. Epub 2021 Jun 12.

Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark.

Background: In the North Denmark Region with a population of 580,000 the awareness of eosinophilic oesophagitis (EoE) increased after 2011 due to a regional biopsy guideline. However, very little was known of the incidence, diagnostic process, or complications of EoE in Denmark.

Objective: The objectives of the study were to establish a cohort of EoE patients and describe the incidence, diagnostic process, and complications of EoE. Read More

Expert Opin Drug Saf 2021 Jun 11. Epub 2021 Jun 11.

Div. Allergy and Immunology, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Charitéplatz 1, 10117 Berlin, Germany.

Introduction: Dupilumab, the first biologic drug to be approved for the treatment of moderate to severe atopic dermatitis in adolescents and adults, has shown efficacy and safety in clinical trials. Data on long-term safety is limited but crucial for pharmacovigilance. Therefore, we performed this review to evaluate available real-world data on the long-term safety of dupilumab in atopic dermatitis. Read More

Case Rep Oncol Med 2021 12;2021:8845063. Epub 2021 May 12.

Blue Ridge Cancer Care, 2013 S Jefferson St, Roanoke, VA 24014, USA.

. The role of immunotherapy continues to evolve across both solid and hematologic malignancies. However, while use of immunotherapy has increased via the advent of checkpoint inhibition, chimeric antigen receptors, and vaccines against malignant cells, there remains uncertainty regarding the recognition and management of delayed immune-related reactions and post treatment immune-related sensitivity to subsequent medications, such as BRAF/MEK kinase inhibitors. Read More

Ann Med Surg (Lond) 2021 Jun 15;66:102376. Epub 2021 May 15.

Department of Dermatology and Venerology, Ibn Rochd University Hospital, Casablanca, Morocco.

Introduction: and importance - Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare benign microvascular proliferation. It is clinically characterized by intradermal or subcutaneous papules and/or nodules. Treatment consists mainly of surgery or laser therapy, with a high recurrence rate. Read More

Int J Chron Obstruct Pulmon Dis 2021 3;16:1555-1568. Epub 2021 Jun 3.

Division of Pulmonary and Critical Care, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.

Objective: This real world study evaluated the effectiveness of switching to closed triple therapy from mono/dual combination or open triple therapy in patients with chronic obstructive pulmonary disease (COPD).

Methods: We conducted this retrospective study at a single medical center from December 2014 to September 2020. Patients with COPD who were stepped up to triple therapy were enrolled. Read More

Eur Heart J Case Rep 2019 Dec 26;3(4):1-6. Epub 2019 Oct 26.

Cardiology Department, Royal Free Hospital, Pond Street, London NW3 2QG, UK.

Background: Acute ST elevation myocardial infarction (STEMI) is a medical emergency and is most commonly due to atherosclerotic plaque rupture and occlusion of coronary vessels. This case demonstrates that eosinophilic granulomatosis with polyangiitis (EGPA) myocarditis can mimic acute STEMI.

Case Summary: A 44-year-old woman presented with acute chest pain, shortness of breath, and collapse with ST elevation on electrocardiography. Read More

Neuroophthalmology 2021 25;45(2):109-116. Epub 2020 Jun 25.

Birmingham Neuro-Ophthalmology, Queen Elizabeth Hospital, Birmingham, UK.

Eosinophilic granulomatosis with polyangiitis (eGPA) is a rare vasculitis of small-medium sized vessels that can cause both anterior and posterior ischaemic optic neuropathies. Herein, the authors present a rare case of eGPA presenting initially as an acute unilateral anterior ischaemic optic neuropathy from short posterior ciliary artery vasculitis. The diagnosis presented a challenge as clinical and histopathological evidence suggested allergic rhinosinusitis, and no invasive fungal sinusitis was found. Read More

Am J Surg Pathol 2021 Jul;45(7):895-904

Department of Pathology, Massachusetts General Hospital, Harvard Medical School.

Peripheral T-cell lymphoma (PTCL) comprises a heterogenous group of rare mature T-cell neoplasms. While some PTCL subtypes are well-characterized by histology, immunophenotype, and recurrent molecular alterations, others remain incompletely defined. In particular, the distinction between CD30+ PTCL, not otherwise specified and anaplastic lymphoma kinase (ALK)-negative anaplastic large cell lymphoma can be subject to disagreement. Read More

Cureus 2021 May 4;13(5):e14848. Epub 2021 May 4.

Paediatrics, Paediatric Professorial Unit, Teaching Hospital, Batticaloa, LKA.

Introduction Chronic urticaria is one of the growing problems worldwide and the prevalence is increasing. Around 2% of children have been shown to be affected with chronic urticaria. Objectives To evaluate demographic, clinical and aetiological factors related to chronic urticaria in children and to assess investigations and treatment. Read More

BMJ Case Rep 2021 Jun 8;14(6). Epub 2021 Jun 8.

Department of Dermatology, Mohammed V University of Rabat, Rabat, Morocco.

Hypereosinophilic syndrome (HES) is a rare haematologic disorder characterised by unexplained, persistent eosinophilia with organ involvement. We report the case of a 74-year-old patient who presented with a pemphigoid-like bullous rash as the only manifestation of an HES. This report highlights the importance of the dermatological manifestations of this potentially life-threating condition that may initially present as a skin-limited disease. Read More

Diagn Pathol 2021 Jun 8;16(1):49. Epub 2021 Jun 8.

Department of Laboratory Medicine and Pathology, University of Washington Medical Center, Box 356100, 1959 NE Pacific St, Seattle, WA, 98195, USA.

Background: Esophageal granular cell tumor (eGCT) is rare, and the recent literature suggests a link between eosinophilic esophagitis (EoE) and eGCT. The aim of our study was to determine if EoE or other disorders associated with eosinophilia are consistently associated with eGCT.

Methods: We retrospectively searched pathology databases of three academic institutions from 1999 to 2018 for eGCTs. Read More

Histopathology 2021 Jun 8. Epub 2021 Jun 8.

Department of Pathology, Shenzhen Hospital of Peking University, Shenzhen, China.

Aim: To compare the fibroinflammatory diseases Kimura's disease (KD) and IgG4-related disease (IgG4RD) and to explore their possible relationship.

Methods And Results: 46 cases of KD and 29 IgG4RD of our institution diagnosed from 2011 to 2020 were studied. They were compared with each other on clinical, pathological and immunohistological features. Read More

Am J Case Rep 2021 Jun 8;22:e931647. Epub 2021 Jun 8.

School of Medicine, Saint Louis University, Saint Louis, MO, USA.

BACKGROUND Vancomycin is an antibiotic commonly used for management of severe gram-positive infections. It is infrequently associated with hematologic adverse effects, ranging from isolated thrombocytopenia or neutropenia to pancytopenia. Although the mechanism is poorly understood, it is considered an immune-mediated phenomenon. Read More

Clin Respir J 2021 Jun 7. Epub 2021 Jun 7.

Department of Chest Diseases, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital Health Sciences University, Istanbul, Turkey.

Introduction: Hyponatremia is shown to prolong hospitalization and increase mortality. The role of hyponatremia in chronic obstructive pulmonary disease is widely studied with a focus on hospitalized patients.

Objectives: To investigate whether hyponatremia increases the probability of re-exacerbations in non-hospitalized patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Read More

Semin Immunopathol 2021 Jun 7. Epub 2021 Jun 7.

Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Eosinophil infiltration is a common finding in a broad spectrum of skin diseases, despite the fact that the skin is devoid of eosinophils under physiologic conditions. Although cutaneous eosinophilia is reactive, cytokine-mediated in most cases, diseases with an intrinsic mutation-mediated clonal expansion of eosinophils can also manifest on the skin. As eosinophils are involved in host defense, regulate immune responses, generate pruritus, induce remodeling and fibrosis, and can cause tissue damage, they have the capacity to actively contribute to the pathogenesis of diseases. Read More

Semin Immunopathol 2021 Jun 7. Epub 2021 Jun 7.

Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland.

Despite dramatic advances in our understanding of the pathogenesis and course of disease in the relatively short timeframe since the discovery and first description of eosinophilic esophagitis (EoE) less than three decades ago, many open questions remain to be elucidated. For instance, we will need to better characterize atypical clinical presentations of EoE and other forms of esophageal inflammatory conditions with often similar clinical presentations, nut fulfilling current diagnostic criteria for EoE and to determine their significance and interrelationship with genuine EoE. In addition, the interrelationship of EoE with other immune-mediated diseases remains to be clarified. Read More

IDCases 2021 19;25:e01166. Epub 2021 May 19.

St. Joseph's/Candler Health System, Inc., 5353 Reynolds Street, Savannah, GA, 31405, USA.

Eosinophilic pneumonia (EP) is characterized by accumulation of eosinophils in the lungs and has been associated with several medications, including antimicrobials. Cefepime is a commonly used broad-spectrum antimicrobial agent for the treatment of nosocomial infections but to date has not been associated with EP. We report the first documented case of EP secondary to cefepime for the treatment of pneumonia. Read More

Front Immunol 2021 19;12:595369. Epub 2021 May 19.

Department of Pulmonary and Critical Care Medicine, Shanghai Institute of Respiratory Disease, Zhongshan Hospital, Fudan University, Shanghai, China.

Background: Previous studies have shown that lipopolysaccharide (LPS)-activated bone marrow-derived dendritic cells (DClps) might induce tolerance in autoimmune and cancer models , whereas it remains unclear whether DClps could play a role in allergic disease model. Herein, we aimed to elucidate the potential effects of DClps on OVA-sensitized/challenged airway inflammation in a mouse model, which may help facilitate the application of specific tolerogenic dendritic cells (tolDC) in allergic asthma in the future.

Methods: The phenotype and function of immature DC (DCia), DClps or IL-10-activated-DC (DC10) were determined. Read More

Intern Med 2021 Jun 5. Epub 2021 Jun 5.

Department of Internal Medicine, Teikyo University School of Medicine, Japan.

A 39-year-old man presented with peripheral eosinophilia, pulmonary eosinophilic infiltrate, and renal failure due to acute tubulointerstitial nephritis (TIN). He had experienced childhood asthma and was negative for anti-neutrophil cytoplasmic antibody (ANCA). He was tentatively diagnosed with ANCA-negative eosinophilic granulomatous polyangiitis (EGPA) or idiopathic hypereosinophilic syndrome (HES). Read More

Intern Med 2021 Jun 5. Epub 2021 Jun 5.

Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan.

Eosinophilic granulomatosis with polyangiitis (EGPA) is an anti-neutrophilic cytoplasm antibody (ANCA)-associated vasculitis characterized by asthma and eosinophilia. Although EGPA involves multiple organs, ocular involvement is infrequent and often carries a poor visual prognosis. We herein report a rare case of EGPA presenting with central retinal artery occlusion (CRAO) in which visual loss developed during treatment with anti-interleukin (IL)-5 receptor monoclonal antibody, and improvement in visual outcomes was attained after treatment combining high-dose oral corticosteroids, cyclophosphamide and an anticoagulant. Read More

J Pak Med Assoc 2021 May;71(5):1489-1492

Department of Infectious diseases, Faculty of Medical Sciences, University of Kragujevac, Serbia.

Fever of unknown origin (FUO) presents a major diagnostic challenge as it is a consequence of many infectious as well as malignant, rheumatologic and other diseases. Here we present the case of a woman with mediastinal and abdominal lymphadenopathy who was initially suspected to have lymphoproliferative disease, but our histopathologic examination revealed sarcoidosis. Sarcoidosis, especially chronic, is a rare cause of FUO, because it usually manifests as a febrile condition. Read More

Am J Clin Oncol 2021 Jun 7. Epub 2021 Jun 7.

Department of Internal Medicine/Pediatrics, The University of Texas Health Science Center Departments of Gastroenterology, Hepatology, and Nutrition Biostatistics Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX Department of Internal Medicine, University of Missouri, Kansas City, MO Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China.

Background: Eosinophilic colitis (EoC) is a rare form of eosinophilic gastrointestinal disease characterized by diffuse eosinophilic infiltration in the deep lamina propria of colonic mucosa. The pathophysiology is unclear, but EoC has been associated with multiple known risk factors.

Aim: The aim of this study was to characterize the clinical characteristics and disease course of patients with EoC at a major cancer center. Read More

Adv Med Sci 2021 Jun 3;66(2):279-283. Epub 2021 Jun 3.

Department of Gastroenterology and Hepatology, Wroclaw Medical University, Wroclaw, Poland.

Purpose: The study aimed to assess the level of inflammatory biomarkers related to eosinophilia: interleukins 5 (IL-5) and 13 (IL-13), eotaxin 3, major basic protein (MBP) and transforming growth factor β1 (TGF-β1) in patients with dysphagia and Schatzki ring (SR), as well as the characteristics of this group of patients in terms of the features differentiating gastroesophageal reflux disease (GERD) and eosinophilic esophagitis (EoE).

Patients And Methods: We analyzed 42 patients with dysphagia, each of whom underwent panendoscopy with an assessment of the occurrence of SR, retrospectively assessed EoE Endoscopic Reference Score (EREFS) total, inflammatory and fibrostenotic and serum concentrations of IL-5 and 13, TGF-β1, eotaxin 3 and MBP. All of them completed a symptom and comorbid questionnaire. Read More

Arab J Gastroenterol 2021 Jun 2. Epub 2021 Jun 2.

Department of Hepatogastroenterology, Theodor Bilharz Research Institute, Giza, Egypt; Department of Pathology, Theodor Bilharz Research Institute, Giza, Egypt; Department of Tropical Medicine and Hepatogastroenterology, Faculty of Medicine, Cairo University, Cairo, Egypt; Service d'Hépatologie, Hôpital Beaujon, APHP, Clichy-la-Garenne, CRI-UMR 1149, Inserm and Université de Paris, Paris, France.

Background: Eosinophilic gastroenteritis (EGE) is defined by the presence of gastrointestinal symptoms, with an abnormal eosinophilic infiltrate of the intestine wall and exclusion of other causes of secondary eosinophilia. EGE has three clinical presentations, depending on the depth of eosinophilic infiltration of the bowel wall. It individualizes into three types, namely mucosal, muscular, and subserosal. Read More

Clin Gastroenterol Hepatol 2021 Jun 2. Epub 2021 Jun 2.

Baylor College of Medicine, Houston, TX.

Background & Aims: Eosinophilic gastritis (EG) and eosinophilic duodenitis (EoD), characterized by chronic gastrointestinal (GI) symptoms and increased numbers or activation of eosinophils and mast cells in the GI tract, are likely underdiagnosed. We aimed to determine rates of EG and EoD and number of biopsies required to optimize detection using screening data from a randomized trial of lirentelimab (AK002), an antibody against siglec-8 that depletes eosinophils and inhibits mast cells. We also characterized endoscopic features and symptoms of EG and EoD. Read More

J Cell Mol Med 2021 Jun 4. Epub 2021 Jun 4.

Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea.

Accumulating evidence reveals that ROS is one of the key mediators that contribute to the development of asthma. Studies on antioxidants have shown to have beneficial effects on asthma management. However, we still do not know the precise mechanism, and the effects depend on age. Read More

Front Immunol 2021 18;12:601842. Epub 2021 May 18.

Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia.

Asthma is a heterogeneous inflammatory disease characterized by airflow obstruction, wheezing, eosinophilia and neutrophilia of the airways. Identification of distinct inflammatory patterns characterizing asthma endotypes led to the development of novel therapeutic approaches. Cytokine or cytokine receptor targeting by therapeutic antibodies, such as anti-IL-4 and anti-IL-5, is now approved for severe asthma treatment. Read More

J Oral Maxillofac Pathol 2021 Mar 19;25(Suppl 1):S42-S45. Epub 2021 Mar 19.

Department of Public Health Dentistry, Bareilly International University, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India.

Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is an ulcerative condition of the oral mucosa amid a chronic course and delayed healing. It is a reactive lesion that usually affects the tongue. TUGSE is a rare mucosal lesion to aid as an ulcer or an indurated submucosal mass and might cause diagnostic problems as it mimics a traumatic or neoplastic ulcer. Read More

Forensic Sci Int 2021 Jul 23;324:110850. Epub 2021 May 23.

Department of Periodontics, Bangalore Institute of Dental Sciences and Post Graduate Research Centre, 5/3, Hosur road Bangalore, 560029 Karnataka, India.

Thanatochemistry also known as chemistry of death and is used to determine post mortem interval (PMI). It is arguably one of the critical steps in forensic investigation. Recent addition of analyzing biochemical changes along with the traditional methods have gained importance, as they help us to record very early changes in the tissue specimens. Read More

Epileptic Disord 2021 Jun 3. Epub 2021 Jun 3.

Neurology Department, Federal University of Paraná, Curitiba, Brazil.

Objective: To describe the clinical characteristics of cutaneous adverse reactions and cross-sensitivity induced by antiseizure medications and compare the pattern of use of antiseizure medications in patients with epilepsy according to skin rash history.

Methods: We analysed patients with a history of skin rash presenting for up to 12 weeks after initiating antiseizure medication. The history of skin rash was verified by medical charts, interviews, and identification of skin lesions by patients based on illustrative images. Read More