• Title, Summary, Keyword: Mucosal eosinophilia

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A Case of Eosinophilic Gastroenteritis (호산구성 위장관염 1례)

  • Lee, Hwa Yun;Kim, Chan Jong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.2
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    • pp.239-242
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    • 2004
  • Eosinophilic gastroenteritis is a rare condition of unknown etiology characterized by peripheral eosinophilia, eosinophilic infiltration of the gastrointestinal tract, and gastrointestinal symptoms. Eosinophilic gastroenteritis is generally classified according to the Klain classification: predominant mucosal, muscular, and subserosal disease. Mucosal involvement may result in abdominal pain, nausea, vomiting, diarrhea, weight loss, anemia, protein-losing enteropathy, and intestinal perforation. Patients with muscular layer disease generally have obstructive symptoms. Subserosal eosinophilic infiltration may result in development of eosinophilic ascites. Most commonly, the stomach, duodenum, and small bowel are involved. A 13-year-old girl came to our hospital presenting with chronic, intermittent abdominal pain. She showed peripheral eosinophilia and biopsy specimen of the duodenum revealed eosinophilic infiltration of the mucosal layer. We here report a case of eosinophilic gastroenteritis.

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Mucosal immunity against parasitic gastrointestinal nematodes

  • Onah, Denis-Nnabuike;Nawa, Yukifumi
    • The Korean Journal of Parasitology
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    • v.38 no.4
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    • pp.209-236
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    • 2000
  • The last two decades witnessed significant advances in the efforts of immune-parasitologists to elucidate the nature and role of the host mucosal defence mechanisms against intestinal nematode parasites. Aided by recent advances in basic immunology and biotechnology with the concomitant development of well defined laboratory models of infection, immunoparasitologists have more precisely analyzed and defined the different immune effector mechanisms during the infection; resulting in great improvement in our current knowledge and understanding of protective immunity against gastrointestinal (GI) nematode parasites. Much of this current understanding comes from experimental studies in laboratory rodents, which have been used as models of livestock and human GI nematode infections. These rodent studies, which have concentrated on Heligmosomoides polygyrus, Nippostrongylus brasiliensis, Strongyloides ratti/5. venezuelensis. Trichinella spiralis and trichuris muris infections in mice and rats, have helped in defining the types of T cell responses that regulate effector mechanisms and the effector mechanisms responsible for worm expulsion. In addition, these studies bear indications that traditionally accepted mechanisms of resistance such as eosinophilia and IgE responses may not play as important roles in protection as were previously conceived. In this review, we shall, from these rodent studies, attempt an overview of the mucosal and other effector responses against intestinal nematode parasites beginning with the indices of immune protection as a model of the protective immune responses that may occur in animals and man.

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Relationship between gastric mucosal eosinophilia and the presence of Helicobacter pylori in Republic of Korea Air Force soldiers (대한민국 공군 장병을 대상으로 한 위점막 조직 호산구 증가증과 유문나선균 간의 관계 연구)

  • Kim, Hyun-Soo;Lee, Sang-Hwa;Lee, Seok;Choi, Won-Ho;Kim, Ji-Ho
    • Journal of the Korean Society for Aviation and Aeronautics
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    • v.20 no.1
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    • pp.34-38
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    • 2012
  • 호산구는 염증 반응에 의해 활성화되며, 주로 기생충 감염이나 알러지 질환 등에 대한 면역 작용을 담당한다고 알려져 있다. 호산구 증가증은 약물 반응, 알러지, 국소적인 기생충 감염 등에 의한 경우가 많지만, 자가면역성 질환이나 종양에 의한 경우도 있다. 최근 연구를 통해 위염의 대표적인 원인균 중 하나인 유문나선균 역시 위점막에서 나타나는 조직 호산구 증가증의 원인이 될 수 있다고 밝혀지고 있으나, 유문나선균에 의한 호산구 증가증 발생 기전이나 빈도는 아직까지 확립되지 않고 있다. 위점막 내 호산구 침윤과 동반되는 위염은 복통, 오심, 구토, 설사, 장폐색 등을 일으킬 뿐만 아니라, 아토피성 피부염, 천식, 위식도 역류, 염증성 장질환 등의 발생과 관련이 있다고 보고되고 있다. 위염 및 다양한 관련 질환에 의한 증상은 공중 근무자들의 임무 수행 능력을 저하시켜 항공기 사고를 발생시킬 수 있는 가능성을 가지고 있다는 점에서 항공의학적으로 매우 중요하며, 실제로 호산구성 위염이나 유문나선균 감염의 치료 여부가 공중 근무자에게 일시적 또는 영구적 비행임무정지를 부과할 수 있는 기준이 되기도 한다. 본 연구에서는 대한민국 공군 장병 환자를 대상으로 내시경을 통해 얻은 위점막 조직 내 호산구수를 측정하고, 이를 위점막 표면의 유문나선균 존재 유무와 관련지어 보았다. 111명 중 20명의 환자에서 한 고배율 시야 당 30개 이상의 호산구가 관찰되었고, 63명의 환자의 위점막 표면에서 유문나선균을 확인하였다. 또한 위점막 내 호산구의 밀도와 유문나선균의 존재 간의 관계는 통계학적으로 유의하였다. 본 연구의 결과는 대한민국 공군 장병을 대상으로 하여 조직 호산구 증가증과 유문나선균의 빈도 및 상호 관계를 최초로 분석했다는 점에서 의의가 있으며, 추후 유문나선균이 어떤 기전으로 위점막 조직 내 호산구의 증가에 관여하는지에 대한 연구를 진행하기 위한 기초 자료로서 활용될 수 있을 것이다.

Eosinophilic Enteritis Presenting as Massive Ascites after Influenza A Virus Infection in a Young Female (젊은 여성에서 인플루엔자 A 바이러스 감염 후 발생한 복수를 동반한 호산구성 소장염 1예)

  • Kim, Myung Jin;Oh, Myung Jin
    • The Korean Journal of Gastroenterology
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    • v.74 no.3
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    • pp.163-167
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    • 2019
  • Eosinophilic gastrointestinal disorder (EGID) is an uncommon disease that is accompanied by intestinal eosinophil infiltration without a secondary cause of eosinophilia. Eosinophilic enteritis is a secondary portion of EGID that can present a range of gastrointestinal symptoms according to the affected depth of the intestinal layer. The subserosal type of eosinophilic enteritis presenting as ascites is relatively rarer than the mucosal type. In general, eosinophilic enteritis occurs in patients with food allergies, but its mechanism is unclear. The authors experienced a 29-year-old female patient with a large amount of ascites with diarrhea and abdominal pain. The patient was diagnosed with an influenza A infection one week earlier. Peripheral eosinophilia (absolute eosinophil count: 6,351 cells/㎣) and eosinophilic ascites (97% of white blood cells in the ascites are eosinophil) were present. Abdominal CT revealed a large amount of ascites and edematous changes in the ileum and ascending colon wall. A diagnosis of eosinophilic enteritis was confirmed as eosinophilic ascites by paracentesis, with eosinophil infiltration of the bowel wall by an endoscopic biopsy. The patient's symptoms improved rapidly after using steroids. To the best of the author's knowledge, this is the first report of eosinophilic enteritis with massive ascites after an influenza A virus infection in a Korean adult.

A Case of Churg-Strauss Syndrome with Multiple Tracheobronchial Mucosal Lesions (기관과 기관지내 다발성 점막 병변을 동반한 Churg-Strauss 증후군 1예)

  • Boo, Sun-Jin;Lee, Kwangha;Ra, Seung Won;Jin, Young-Joo;Park, Gyung-Min;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.5
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    • pp.405-409
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    • 2008
  • Churg-Strauss syndrome is a rare form of systemic necrotizing vasculitis that occurs exclusively in patients with asthma, and is associated with blood and tissue eosinophilia. The classic pathology findings in the lung include a combination of eosinophilic pneumonia, granulomatous inflammation and necrotizing vasculitis. However, there are few reports of tracheobronchial mucosal lesions in Churg-Strauss syndrome. We report a case of Churg-Strauss syndrome with multiple tracheobronchial mucosal lesions in a 33-year-old man with a history of bronchial asthma and allergic rhinitis. He had been diagnosed with community acquired pneumonia at another hospital and was treated with antibiotics. However, the chest radiographic findings were aggravated and showed multifocal consolidations in the whole lung fields. He was transferred to the Asan Medical Center. Fiberoptic bronchoscopy revealed multiple nodular mucosal lesions of the trachea and bronchi. The histopathology of the mucosal lesions revealed necrotizing bronchial inflammation with eosinophilic infiltration. Video Assisted Thoracic Surgery was performed. The wedge resected lung tissue revealed chronic eosinophilic pneumonia that was consistent with Churg-Strauss syndrome. Methylprednisolone (1 mg/kg q 8 hr) was prescribed and his symptoms resolved gradually. The chest radiographic findings improved significantly, and a follow-up fiberoptic bronchoscopy performed eight days later showed that the tracheobronchial mucosal lesions had resolved. The patient was prescribed oral prednisolone for 20 months after discharge. Currently, the patient is not taking steroids and is being followed up.

Clinical Manifestations and Treatment Outcomes of Eosinophilic Gastroenteritis in Children

  • Choi, Jong Sub;Choi, Shin Jie;Lee, Kyung Jae;Kim, Ahlee;Yoo, Jung Kyung;Yang, Hye Ran;Moon, Jin Soo;Chang, Ju Young;Ko, Jae Sung;Kang, Gyeong Hoon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.4
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    • pp.253-260
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    • 2015
  • Purpose: The aim of the present study was to investigate the clinical features and outcome of eosinophilic gastroenteritis (EGE) in children. Methods: Our study enrolled 24 children who were diagnosed with EGE from 1993 to 2014 at the Department of Pediatrics, Seoul National University Children's Hospital. The patients' clinical manifestations, treatments, and outcomes were reviewed from the medical records. Results: The mean age at diagnosis was 5.3 years. Most patients had gastrointestinal symptoms including diarrhea (54.2%) and abdominal pain (45.8%). Peripheral eosinophilia was present in 91.7% of the patients. Thirteen patients (54.2%) showed anemia, and 15 patients (62.5%) had hypoalbuminemia. EGE was classified as mucosal, subserosal, or muscular in 75.0%, 20.8%, and 4.2% of cases, respectively. Three patients showed gastroduodenal ulcers upon endoscopic analysis. A history of allergy was reported in 13 patients, including atopic dermatitis, allergic rhinitis, and asthma. Five patients (20.8%) improved with food restrictions. Among the 19 patients treated with steroids, 11 (57.9%) discontinued steroid treatment without subsequent relapse, 4 (21.1%) relapsed after ceasing steroid treatment, and 4 (21.1%) showed no response to steroids. Two patients who were resistant to steroids underwent therapeutic surgery. The presence of gastroduodenal ulcers was significantly associated with relapse and steroid resistance. Conclusion: A high suspicion of EGE is warranted when children have nonspecific gastrointestinal symptoms and peripheral eosinophilia. Most patients improved with food restrictions or steroid treatment, although one-third of patients showed a relapse or steroid resistance.

Baculovirus-based Vaccine Displaying Respiratory Syncytial Virus Glycoprotein Induces Protective Immunity against RSV Infection without Vaccine-Enhanced Disease

  • Kim, Sol;Chang, Jun
    • IMMUNE NETWORK
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    • v.12 no.1
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    • pp.8-17
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    • 2012
  • Background: Respiratory syncytial virus (RSV) is a major cause of severe lower respiratory tract diseases in infancy and early childhood. Despite its importance as a pathogen, there is no licensed vaccine against RSV yet. The attachment glycoprotein (G) of RSV is a potentially important target for protective antiviral immune responses. Recombinant baculovirus has been recently emerged as a new vaccine vector, since it has intrinsic immunostimulatory properties and good bio-safety profile. Methods: We have constructed a recombinant baculovirus-based RSV vaccine, Bac-RSV/G, displaying G glycoprotein, and evaluated immunogenicity and protective efficacy by intranasal immunization of BALB/c mice with Bac-RSV/G. Results: Bac-RSV/G efficiently provides protective immunity against RSV challenge. Strong serum IgG and mucosal IgA responses were induced by intranasal immunization with Bac-RSV/G. In addition to humoral immunity, G-specific Th17- as well as Th1-type T-cell responses were detected in the lungs of Bac-RSV/G-immune mice upon RSV challenge. Neither lung eosinophilia nor vaccine-induced weight loss was observed upon Bac-RSV/G immunization and subsequent RSV infection. Conclusion: Our data demonstrate that intranasal administration of baculovirus-based Bac-RSV/G vaccine is efficient for the induction of protection against RSV and represents a promising prophylactic vaccination regimen.