1/69. Mistaken diagnosis of eosinophilic colitis.A 69-year-old male chronic alcohol abuser suffering from diarrhoea and with a number of discrete pruriginous and erythematous lesions of the trunk was referred to our Unit with a diagnosis of idiopathic eosinophilic colitis in order that we might determine corticosteroid treatment. Diagnosis was based on the presence of marked peripheral eosinophilia and massive eosinophilic infiltration at colonic biopsy, and the exclusion of parasitic infection by means of two different microscopic stool examinations of five samples. However, repeated stool examinations of ten samples collected on separate days and evidence of impaired cell-mediated immunity allowed a definite diagnosis of strongyloides stercoralis autoinfection or hyperinfection. Due to the poor sensitivity of stool examination in the diagnosis of strongyloides stercoralis infection, a careful search for this parasite should be made in all patients with comparable clinical findings before formulating a diagnosis of idiopathic eosinophilic colitis, because consequent steroid treatment may have a fatal outcome by inducing widespread dissemination of the parasite.- - - - - - - - - - ranking = 1keywords = fat (Clic here for more details about this article) |
2/69. Recurrent eosinophilic panniculitis associated with fasciola hepatica infection.Eosinophilic panniculitis is characterized by a prominent infiltration of subcutaneous fat with eosinophils. We report a case of fasciola hepatica infection presenting with eosinophilic panniculitis successfully treated with bithionol. To our knowledge, this is the first report of recurrent eosinophilic panniculitis associated with fasciola hepatica infection.- - - - - - - - - - ranking = 879.91499741785keywords = subcutaneous fat, fat (Clic here for more details about this article) |
3/69. Medullary CD30 T cell lymphoma with eosinophilia and hyper-IgE supervening during the relentless course of pityriasis lichenoides.We report a case of extensive pityriasis lichenoides exhibiting a relentless course. puva therapy and oral retinoids cleared temporarily the lesions but did not really halt the course of the disease. eosinophilia and hyper-IgE occurred after 50 years of evolution. An aggressive medullary CD30 T cell lymphoma without skin involvement was then diagnosed when pityriasis lichenoides became more extensive and necrotic. The disease was rapidly fatal.- - - - - - - - - - ranking = 1keywords = fat (Clic here for more details about this article) |
4/69. MR findings of eosinophilic meningoencephalitis attributed to angiostrongylus cantonensis.Eosinophilic meningoencephalitis is prevalent and widely distributed in thailand, especially in the northeastern and central parts of the country. Angiostrongylus cantonensis is one of the causative agents of fatal eosinophilic meningoencephalitis. The nematodes produce extensive tissue damage by moving through the brain and inducing an inflammatory reaction. We report the clinical features and the findings revealed by MR imaging and MR spectroscopy in six patients with eosinophilic meningoencephalitis. The clinical presentation included severe headache, clouded consciousness, and meningeal irritation. Abnormal findings on MR images included prominence of the Virchow-Robin spaces, subcortical enhancing lesions, and abnormal high T2 signal lesions in the periventricular regions. Proton brain MR spectroscopy was performed in three patients and was abnormal in one severe case, showing decreased choline in a lesion. Small hemorrhagic tracts were found in one case. Lesions thought to be due to microcavities and migratory tracts were found in only one case. We believe the MR imaging and MR spectroscopy findings are of diagnostic value and helpful in understanding the pathogenetic mechanisms of the disease.- - - - - - - - - - ranking = 1keywords = fat (Clic here for more details about this article) |
5/69. Eosinophilic ileocolitis secondary to enterobius vermicularis: case report.We describe an unusual presentation of enterobius vermicularis infestation. Computed tomography showed wall thickening in the distal ileum and cecum, with fat stranding, ascites and mesenteric adenopathy. Fluoroscopic examination confirmed distal ileal transverse fold thickening. Isolation of enterobius vermicularis in stool and biopsy confirmed the diagnosis. enterobius should be included among the causes of eosinophilic ileocolitis.- - - - - - - - - - ranking = 1keywords = fat (Clic here for more details about this article) |
6/69. Acute eosinophilic myocarditis in a young woman.The first stage of eosinophilic myocarditis is called the necrotizing phase. This stage of eosinophilic myocarditis of unknown cause is often fulminant and rapidly fatal, occurring predominantly in males. Here, we report a case of eosinophilic myocarditis in the acute necrotizing phase occurred without known cause in a 23-year-old Japanese female. Severe diffuse hypokinesis of the left ventricular wall motion (ejection fraction 19.3%), significant concentric edematous thickening of the left ventricular wall (20.1 mm in diastole) and a moderate amount of pericardial effusion (10 mm wide echo free space posteriorly) were revealed by echocardiography. eosinophils were observed and degranulated eosinophilic cationic proteins were stained with antibody against eosinophilic cationic proteins (EG2) in the myocardial specimens obtained by myocardial biopsy. In spite of its severity, the disease resolved promptly with steroid therapy.- - - - - - - - - - ranking = 1keywords = fat (Clic here for more details about this article) |
7/69. Eosinophilic pancreatitis: a rare entity that can mimic a pancreatic neoplasm.Eosinophilic pancreatitis is a rare disorder that is frequently diagnosed only after pancreatic resection for suspected pancreatic tumor. It typically occurs in the setting of either eosinophilic gastroenteritis or the hypereosinophilic syndrome. Isolated eosinophilic infiltration of the pancreas is less common. We describe a case of a 36-year-old man who presented with the clinical symptoms of acute pancreatitis. Radiologic evaluation revealed an obstructive pancreatic lesion suspicious for carcinoma. Pathologic examination of the resection specimen revealed a dense infiltrate of eosinophils in the pancreas. Although an uncommon condition, eosinophilic pancreatitis is a syndrome lacking well-defined causes that can be associated with eosinophilic gastroenteritis, a treatable condition, or the potentially fatal hypereosinophilic syndrome. While the radiographic features of this condition can vary widely, eosinophilic infiltration of the pancreas with or without involvement of the gastrointestinal tract is the pathologic feature common to all of the previously reported cases.- - - - - - - - - - ranking = 1keywords = fat (Clic here for more details about this article) |
8/69. churg-strauss syndrome involving medium-sized arteries.A 69-year-old Japanese man suffered from bronchial asthma, atrial fibrillation, general fatigue, high fever, and weight loss of about 5 kg within a month. He also had intermittent claudication, a tingling feeling in his fingers and toes, and an ulcer on his toe. His laboratory data revealed leukocytosis with absolute eosinophilia. The patient was treated with predonisolone 30 mg daily. Although the ulcers healed once, the lesions recurred with tapering predonisolone. The patient visited us because of the ulcer on his toe. physical examination showed a 2 cm ulcer surrounded by slight erythema on his right fourth toe. magnetic resonance angiography detected tapering stenosis of the medium-sized arteries in both legs. A biopsy from his myocardium showed the infiltration of eosinophils into the myocardium. The neuron conduction rate of his lower leg was slower than that of the normal control, demonstrating mononeuritis. From these findings, we diagnosed this patient as churg-strauss syndrome.- - - - - - - - - - ranking = 1keywords = fat (Clic here for more details about this article) |
9/69. Immediate-Type allergy against human insulin associated with marked eosinophilia in type 2 diabetic patient.We describe a type 2 diabetic patient who showed immediate-type allergy against human insulin associated with marked eosinophilia at initial insulin therapy. Three months after initiation of insulin therapy, he noticed itchy skin wheals at the site of the insulin injection. Laboratory data at that time showed marked eosinophilia (2,512 /mm3) and progression of renal dysfunction. skin test with semisynthetic human insulin and protamine sulfate resulted in local immediate skin reactions such as itchy erythema and wheals. Histopathology of the biopsy specimen from skin showed perivascular infiltration of lymphocytes and numerous eosinophils in the dermis and subcutaneous fat. Although the titer of total IgE antibody was within normal range, that of insulin-specific IgE antibody was high. insulin administration was discontinued to preserve his insulin secretion, and stable control of his hyperglycemia was obtained by initiating nateglinide treatment (360 mg/day). His itchy skin lesions disappeared within two weeks after cessation of the insulin therapy and both eosinophilia and renal dysfunction gradually improved. Although the widespread use of human insulin in diabetic patients has greatly reduced the incidence of insulin allergy, the possibility of human insulin allergy should be kept in mind when initiating such therapy.- - - - - - - - - - ranking = 880.91499741785keywords = subcutaneous fat, fat (Clic here for more details about this article) |
10/69. Acute necrotizing eosinophilic myocarditis successfully treated by high dose methylprednisolone.Acute necrotizing eosinophilic myocarditis is the most severe form of eosinophilic myocarditis, or hypersensitivity myocarditis, and is characterized by rapidly progressive congestive heart failure followed by fulminant clinical deterioration that is nearly always fatal. A 55-year-old previously healthy patient with acute necrotizing eosinophilic myocarditis was diagnosed by early myocardial biopsy and successfully treated with corticosteroids. Throughout his hospitalization, the eosinophil count in the peripheral blood remained normal (56-201/mm3). Early stage corticosteroid therapy can have dramatic effects in acute necrotizing eosinophilic myocarditis and early diagnosis by endomyocardial biopsy is recommended.- - - - - - - - - - ranking = 1keywords = fat (Clic here for more details about this article) |
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