- Strongyloides hyper infection in a steroid dependent leprosy patient. [Journal Article]
- LRLepr Rev 2016; 87(4):536-42
- Immunosuppresion caused by corticosteroids predisposes leprosy patients to Strongyloides stercoralis infection which if untreated can be fatal. Patients acquire infection by walking barefoot in infes...
Immunosuppresion caused by corticosteroids predisposes leprosy patients to Strongyloides stercoralis infection which if untreated can be fatal. Patients acquire infection by walking barefoot in infested soils and can be infected for life because of the auto infective cycle of the parasite. Corticosteroids have precipitated death in more than 60% of disseminated strongyloidiasis cases.
- Valaciclovir: a culprit drug for DRESS not to be neglected. Three cases. [Letter]
- BJBr J Dermatol 2018 Sep 17
- Valaciclovir is widely used for the treatment and prevention of Herpesvirus infections, especially in hematological diseases and solid organ transplantation1,2 , and has a very good benefit-to-risk r...
Valaciclovir is widely used for the treatment and prevention of Herpesvirus infections, especially in hematological diseases and solid organ transplantation1,2 , and has a very good benefit-to-risk ratio.3 Thus, its involvement in cases of cutaneous reaction may be neglected, especially if high-risk drugs are used concomitantly. We describe three cases of drug reactions with eosinophilia and systemic symptoms (DRESS) with proven causality by valaciclovir, illustrating this risk. This article is protected by copyright. All rights reserved.
- Chronic Nonallergic Rhinitis. [Journal Article]
- AFAm Fam Physician 2018 Aug 01; 98(3):171-176
- Chronic nonallergic rhinitis encompasses a group of rhinitis subtypes without allergic or infectious etiologies. Although chronic nonallergic rhinitis represents about one-fourth of rhinitis cases an...
Chronic nonallergic rhinitis encompasses a group of rhinitis subtypes without allergic or infectious etiologies. Although chronic nonallergic rhinitis represents about one-fourth of rhinitis cases and impacts 20 to 30 million patients in the United States, its pathophysiology is unclear and diagnostic testing is not available. Characteristics such as no evidence of allergy or defined triggers help define clinical subtypes. There are eight subtypes with overlapping presentations, including nonallergic rhinopathy, nonallergic rhinitis with nasal eosinophilia syndrome, atrophic rhinitis, senile or geriatric rhinitis, gustatory rhinitis, drug-induced rhinitis, hormonal rhinitis, and occupational rhinitis. Treatment is symptom-driven and similar to that of allergic rhinitis. Patients should avoid known triggers when possible. First-line therapies include intranasal corticosteroids, intranasal antihistamines, and intranasal ipratropium. Combination therapy with decongestants and first-generation antihistamines can be considered if monotherapy does not adequately control symptoms. Nasal irrigation and intranasal capsaicin may be helpful but need further investigation.
- Characteristics of patients with severe, uncontrolled, eosinophilic asthma enrolled in a French cohort. [Journal Article]
- JAJ Asthma Allergy 2018; 11:217-224
- CONCLUSIONS: Of patients with severe asthma, approximately 20% were qualified for benralizumab treatment. Benralizumab-eligible patients had increased bronchial obstruction, worse asthma control, and a greater frequency of asthma exacerbations and hospitalizations during follow-up care compared with benralizumab-ineligible patients, demonstrating inadequate disease control for these patients.
- Clinical course and treatment outcomes of toxocariasis-related eosinophilic disorder. [Journal Article]
- MMedicine (Baltimore) 2018; 97(37):e12361
- Blood eosinophilia is a common clinical finding. Helminthic infections, including toxocariasis, are a common cause of eosinophilia; however, the clinical course of toxocariasis associated with eosino...
Blood eosinophilia is a common clinical finding. Helminthic infections, including toxocariasis, are a common cause of eosinophilia; however, the clinical course of toxocariasis associated with eosinophilia is not fully understood. Thus, controversies exist regarding treatment indications.To evaluate the clinical features and natural course of various types of eosinophilia, with a particular focus on toxocariasis, we retrospectively reviewed the medical records of 1000 patients with peripheral blood eosinophilia who were referred to the allergy clinic at Asan Medical Center between 2007 and 2012. Clinical parameters and imaging study findings were evaluated. The treatment response to albendazole and resulting changes in eosinophilia and imaging studies were analyzed in patients diagnosed with toxocariasis.Among the 1000 subjects, toxocariasis was the most common cause of eosinophilia (n = 534; 53.4%), followed by allergic disease and adverse drug reactions. The majority of patients with toxocariasis were men, and they were mostly asymptomatic. More than one-third of patients (n = 215; 40.3%) with toxocariasis exhibited organ involvement, particularly hepatic involvement. In most cases of eosinophilia and organ involvement due to toxocariasis, the symptoms normalized regardless of treatment.Most cases of eosinophilia related to toxocariasis displayed a self-remitting course regardless of treatment. With the exception of several clinical situations, including ocular involvement, the clinical need for anti-helminthic therapy in toxocariasis is not that significant.
- Impact of Gastroesophageal Reflux Disease on Mucosal Immunity and Atopic Disorders. [Review]
- CRClin Rev Allergy Immunol 2018 Sep 11
- Atopic disorders and gastroesophageal reflux disease (GERD) are some of the most common medical conditions treated by primary care physicians and specialists alike. The observation that atopic disord...
Atopic disorders and gastroesophageal reflux disease (GERD) are some of the most common medical conditions treated by primary care physicians and specialists alike. The observation that atopic disorders, like asthma, allergic rhinitis and sinusitis, food allergies, atopic dermatitis, contact dermatitis, and eosinophilic esophagitis are common comorbidities in patients with GERD raises the question of the nature of the relationship that may exist between GERD and atopic disorders. In this article, we review the pathophysiology of GERD, its effect on the immune system, the effect of acid-blocking medications on allergic responses, as well as several common atopic conditions that have been associated with GERD including asthma, chronic rhinosinusitis (CRS), allergic rhinitis (AR), atopic dermatitis (AD), contact dermatitis (CD), food allergies, proton pump inhibitor (PPI)-responsive esophageal eosinophilia (PPI-REE), and eosinophilic esophagitis (EoE). In each condition, the evidence of a causal link is not definitive. Although the relationship between asthma and GERD remains controversial, evidence suggests that a subset of asthma patients with documented GERD may experience improved asthma control following appropriate treatment of GERD. The relationship of GERD to allergic rhinitis and chronic sinusitis is weak; however, studies support the concept that treatment of frequent episodes of GERD can have a positive effect on rhinitis and sinusitis overall. The relationship between allergic sensitization and GERD is likely bidirectional. GERD may induce changes in the mucosal immune system that may favor the development of food allergy and allergic sensitization to aeroallergens; however, the underlying mechanisms have not been established.
- Clinical features, bacteriology of endotracheal aspirates and treatment outcomes of patients with chronic obstructive pulmonary disease and community-acquired pneumonia in an intensive care unit in Taiwan with an emphasis on eosinophilia versus non-eosinophilia: a retrospective case-control study. [Journal Article]
- BOBMJ Open 2018 Sep 11; 8(9):e020341
- CONCLUSIONS: The results of this study have significant clinical implications and should be considered when making treatment decisions for the management of patients with COPD and CAP requiring IMV and ICU admission.
- How Respiratory Syncytial Virus Genotypes Influence the Clinical Course in Infants Hospitalized for Bronchiolitis. [Journal Article]
- JIJ Infect Dis 2018 Sep 11
- CONCLUSIONS: The disease course in infants hospitalized for acute RSV bronchiolitis may depend on the RSV genotype.
- Case Report: Monoclonal Gammopathy of Undetermined Significance is Associated with Loa loa Infection. [Journal Article]
- AJAm J Trop Med Hyg 2018 Sep 10
- A 63-year-old woman who migrated from Nigeria to the United States was found to have an elevated total serum protein, anemia, and eosinophilia. Serum protein electrophoresis (SPEP) and serum protein ...
A 63-year-old woman who migrated from Nigeria to the United States was found to have an elevated total serum protein, anemia, and eosinophilia. Serum protein electrophoresis (SPEP) and serum protein immunofixation electrophoresis (SPIFE) demonstrated monoclonal IgG κ restricted bands (IgG 3,820 mg/dL; κ/λ ratio 4.47), indicative of monoclonal gammopathy of unknown significance (MGUS). A rapid diagnostic test (RDT) for malaria was positive for Plasmodium falciparum (BinaxNOW®). Giemsa-stained blood smears were negative for malarial parasites, however, Loa loa microfilariae were identified. Reverse transcription polymerase chain reaction for P. falciparum, Plasmodium ovale, Plasmodium malariae, and Plasmodium vivax yielded a negative result. She was treated for loiasis with diethylcarbamazine and received no malaria medication. Treatment resulted in a resolution of the microfilaremia and eosinophilia, a negative RDT for malaria, and marked reduction in the monoclonal gammopathy. This is the first reported human case of MGUS associated with loiasis and its resolution after antiparasitic treatment.
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- [A retrospective study of the clinical characteristics and treatment of 93 adult patients with eosinophilic gastroenteritis]. [Journal Article]
- NSNihon Shokakibyo Gakkai Zasshi 2018; 115(9):797-803
- We performed a retrospective analysis on three patients diagnosed with EGE (eosinophilic gastroenteritis) at our hospital and 90 cases obtained from a case database. The cases' genders, ages, periphe...
We performed a retrospective analysis on three patients diagnosed with EGE (eosinophilic gastroenteritis) at our hospital and 90 cases obtained from a case database. The cases' genders, ages, peripheral eosinophils, ascites, endoscopic findings, biopsy findings, diagnostic scores, and rates of glucocorticoid use were evaluated. The gender ratio was 40 males to 53 females, and the median age was 50. 78.5% of cases had peripheral eosinophilia. The prevalence of allergic diseases was 31.2%, and the incidence of ascites was 34.4%. 83.9% of endoscopic findings were positive, and 92.5% of biopsies were positive. The total rate of glucocorticoid use was 77.4%. When both score <5 and age <33 conditions were met, the rate of glucocorticoid use was approximately 30%, meaning it was possible to avoid glucocorticoid use.