담관염과 췌장염이 병발한 호산구성 담낭염 1예

김영묵(Yeong Muk Kim),이동윤(Dong Yun Lee),이준상(Joon Sang Lee) 대한소화기학회 2000 대한소화기학회지 Vol.35 No.5

Eosinophilic cholecystitis is a rare form of cholecystitis which was first described by the French workers in 1949. Histologically, it is characterized by a dense, transmural leukocyte infiltration and is composed of more than 90% eosinophils. Eosinophilic cholecystitis is usually unsuspected and indistinguishable from calculous cholecystitis. The etiology of eosinophilic cholecystitis is unknown. The several possible reasons are a local eosinophilic inflammatory reaction to gallstone or parasites, a manifestation of eosinophilic gastroenteritis, a systemic hypereosinophilic syndrome, or an allergic hypersensitivity response to drugs or other immunogens. In reviewing the literatures, twelve cases of eosinophilic cholecystitis were reported subsequently. Among the cases, 5 cases were eosinophilic cholecystitis and cholangitis with extrahepatic obstruction. We experienced the case in a 30-year-old man who complained of high fever and right upper quadrant pain. He was diagnosed as having eosinophilic cholecystitis and cholangitis and received cholecystectomy. Here, we present an unusual case of eosinophilic cholecystitis. By the pathological observation, eosinophilic infiltration of all three layers of gall bladder wall was associated with cholangitis, pancreatitis and peripheral eosinophilia. (Kor J Gastroenterol 2000;35:664 - 670)

CCR3 Monoclonal Antibody Inhibits Eosinophilic Inflammation and Mucosal Injury in a Mouse Model of Eosinophilic Gastroenteritis

송대진,심문희,이나현,유영,정지태 대한천식알레르기학회 2017 Allergy, Asthma & Immunology Research Vol.9 No.4

Purpose: Although the role of eosinophils in eosinophilic gastroenteritis (EGE) is not fully understood, they are believed to be a principal effector cell. Previous studies have demonstrated that eotaxin and its specific receptor, cysteine-cysteine chemokine receptor-3 (CCR3), play a central role in eosinophil trafficking into the gastrointestinal (GI) tract. Thus, we examined the targeting of CCR3 as a potential therapeutic intervention for EGE in a mouse model. Methods: Eight- to 10-week-old BALB/c mice were intraperitoneally sensitized and intragastrically challenged with ovalbumin (OVA). Different groups of mice were administered either an anti-CCR3 antibody or a control IgG by intraperitoneal injection 1 hour before each OVA challenge. Eosinophilic inflammation in the intestinal mucosa, mucosal injury, and severity of diarrhea were compared between different groups at 1 hour after final OVA challenge. Results: Anti-CCR3 antibody reduced the number of eosinophils in peripheral blood and intestinal mucosa, but not in bone marrow. This reduction was associated with restoration of reduced villous crypt ratio, increased intestinal epithelial cell proliferation, and weight loss induced by OVA challenge. However, Anti-CCR3 antibody had no effect on the level of OVA specific immunoglobulin E (IgE) and the expression of critical chemokines or cytokines in eosinophil trafficking into the GI tract, such as eotaxin-1, interleukin (IL)-5, and IL-13. Conclusions: Anti-CCR3 antibody significantly reduced the severity of eosinophilic inflammation, mucosal injury, and diarrhea in a mouse model of food allergeninduced GI eosinophilic inflammation. CCR3 may be a novel therapeutic target for treatment of EGE and other GI eosinophil-mediated diseases.

니켈에 의한 호산구성 폐렴

김동규(Dong Gyu Kim),김정한(Jung Han Kim),장현주(Hyun Joo Jang),송진영(Jin Young Song),서승오(Sung O Seo),이승준(Sung Jun Lee),손지웅(Ji Oung Son),박명재(Myoung Jae Park),이명구(Myung Gu Lee),현인규(In Gyu Hyun),정기석(Ki Suck Jung) 대한내과학회 2000 대한내과학회지 Vol.58 No.1

Eosinophilic lung diseases are a heterogeneous group of disorders characterized by eosinophilic pulmonary infiltrates and, commonly peripheral blood eosinophilia. A vast number of drugs have been associated with eosinophilic pneumonia and drug reactions are one of the most commonly reported causes of pulmonary infiltrates with blood and/or alveolar eosinophilia. Nickel exposure may occur in occupations including nickel maker, nickel smelters, stainless steel makers, battery makers, electroformer, electroplater, refining operations etc, and has been associated with an increased risk of lung and nasal cancers. Nickel dust has been reported to induce eosinophilic pneumonia, infrequently. We experienced a case of nickel-induced eosinophilic pneumonia in a 55 years old male patient who has been working at a stainless press factory for 25 years until retirement at January 1998. He complained of dry cough and exertional dyspnea, and presented peripheral eosinophilia and multiple small nodular opacities on chest radiograph. Pathological examination of open lung biopsy revealed diffuse vasculitis involving variable-sized vessels with diffuse infiltration of inflammatory cells, particulary eosinophils. Nickel concentration measured from two dried lung tissue was 39.66 ㎍/g and 25.14 ㎍/g, respectively.(Korean J Med 58:102-106, 2000)

위배출시간의 지연을 동반한 호산구성 위염 1예

배선윤,정호중,김미연,이미래,이혁 대한소화기내시경학회 2009 Clinical Endoscopy Vol.39 No.5

Eosinophilic gastritis is a rare disease that is characterized by eosinophilic infiltration of the bowl wall tissue, and the presentation of symptoms varies depending on the affected site. It is likely that eosinophil-active cytokines play important roles in this disease. A 22-year old man presented with abdominal pain and vomiting. Endoscopic gastric biopsy revealed eosinophilic infiltration, and the serum level of Interleukin (IL)-5 was increased. Gastric emptying was moderately delayed in this patient. The patient was treated with steroid and he showed dramatic clinical improvement with disappearance of the eosinophilic infiltration of the gastric mucosa, normalization of the serum level of IL-5 and improvement of the gastric emptying time. There has been few case reports of eosinophilic gastritis that have described the change of the serum level of cytokines and the gastric emptying. We report here on a case of eosinophilic gastritis and the patient showed elevated serum level of cytokines and delayed gastric emptying. The patient improved after being treated with steroid. 호산구성 위염은 장벽의 병적인 호산구 침윤을 특징으로 한 드문 질환으로, 장관내의 침범 부위에 따라 다양한 임상 증상을 나타낼 수 있으며, 호산구의 활성화와 관련된 사이토카인이 질환에서 중요한 역할을 한다고 알려져 있다. 복통과 구토를 주소로 내원한 환자의 내시경을 통한 위 조직 검사 상에서 호산구의 침윤이 관찰되었고, 혈청 IL-5가 상승되어 있음을 확인하였다. 또한 위 운동장애 여부를 확인하기 위해 시행한 위배출시간 검사에서 중등도의 지연 소견을 보였다. 스테로이드 투여 후 증상의 호전과 함께 조직의 호산구 침윤의 소실, 혈청 IL-5의 정상화 및 위배출시간의 정상화를 확인할 수 있었다. 국내에서 호산구성 위염의 치료 경과에 따른 혈청 사이토카인 및 위배출시간의 변화를 관찰한 예는 아직 보고가 없으며, 저자들은 사이토카인의 상승 및 위배출시간의 지연을 동반한 호산구성 위염에서 스테로이드 투여 후 호전된 예를 경험하여 문헌고찰과 함께 보고한다.

복수를 동반한 호산구성 위장염 1례

한승묵,신원승,김민수,김정희,김성종,정재진,이동욱,이동욱,곽동협 啓明大學校 醫科大學 1998 계명의대학술지 Vol.17 No.3

호산구성 위자염은 툭발성으로 위장관 벽의 호산구 침윤과 말초 혈액내 호산구증다증을 동반하고 다양한 위장관 증상을 나타내는 질환으로 복수가 동반된 경우는 매우 드문 것으로 알려져 있다. 이에 저자들은 최근에 말초 혈액에 호산구증다증과 장점막의 호산구 침윤뿐만 아니라 소산구성 복수가 동반되고 스테로이드 요법으로 잘 치료된 호산구성 위장염 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Eosinophilic gastroenteritis is an uncommon disease of uncertain etiology characterized by eosinophilia in the peripheral blood and eosinophilic infiltrates in the bowel wall. Clinical features vary depending on which layers or regions of the gastrointestinal tract are mainly affected. Mucosal involvement causes malabsorption. protein-losing enteropathy and diarrhea. Infiltration of the muscle layer manifests gastric outlet or small bowel obstruction. Serosal involvement causes an exudative ascites rich in eosinophils. Eosinophilic gastroenteritis with ascites is a rare from of eosinophilic gastroenteritis. In this paper, we present a case of eosinophilic gastroenteritis with ascites demonstrating eosinophilia in the peripheral blood and eosinophilic infiltrates in the mucosal wall. The patient was successfully treated with steroid therapy. In addition to this case report, the several literatures on eosinophilic gastroentritis are reviewed.

Assessment of factors associated with disease severity and prognosis for acute eosinophilic pneumonia patients

최준영,임정욱,이진국 대한결핵 및 호흡기학회 2018 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.126 No.0

Objective: The object of this study was to investigate factors associated with disease severity and prognosis in acute eosinophilic pneumonia (AEP) patients. Methods: We retrospectively reviewed medical records of AEP patients treated at Armed Forces Capital Hospital between May 2012 to May 2017. To assess disease severity of the disease, we analyzed correlations of PF ratio with BAL/blood eosinophil, smoking days and CRP. To investigate prognostic factors, we defined poor prognosis group as patients with prolonged O2 demand (≥2 days). We performed logistic regression on prognosis with age, BAL eosinophil/blood eosinophil, smoking days and CRP. Results: Among total of 344 patients, 99.7% of patients were male and mean age was 20.4±1.4. Only 0.6% of patients were never smoker and mean smoking days were 26.2±25.4. PF ratio showed significant correlation with BAL eosinophil (r=0.207, p<0.01), blood eosinophil (r=0.140, p=0.05), smoking days (r=-0.154, p=0.04) and CRP (r=-0.184 p=0.01). Simple logistic regression on prognosis revealed that CRP (OR=1.07; 95% CI, 1.02-1.11), blood eosinophil (OR=0.87; 95% CI, 0.80-0.93), smoking days (OR 1.01; 95% CI, 1.00-1.02) were statistically significant. By multiple logistic regression, blood eosinophil (OR=0.88; 95% CI, 0.80-0.95) and smoking days (OR 1.01; 95% CI, 1.00-1.02) were significant factors associated with disease prognosis. Conclusions: In this study, severity of AEP was correlated with BAL/blood eosinophil, smoking days and CRP. Furthermore, disease prognosis was revealed to be associated with blood eosinophil and smoking days.

복수를 동반한 호산구성 소장염 1예

윤경택(Kyung Taek Yun),전용철(Yong Cheol Jeon),손영우(Young Woo Son),손주현(Joo Hyun Sohn),윤병철(Byeong Chul Yoon),최호순(Ho Soon Choi),함준수(Joon Soo Hahm),이동후(Dong Hoo Lee),이민호(Min Ho Lee),기춘석(Choon Suhk Kee),박경남(Kyun 대한소화기학회 2000 대한소화기학회지 Vol.35 No.4

Eosinophilic gastroenteritis is a rare disease of unknown cause and presents with tissue eosinophilia, which can involve different layers of gut wall and show different gastrointestinal symptoms according to the invaded lesion or layer without parasitic infestation. A pathologic and clinical classification of eosinophilic gastroenteritis is based on the predominent layer of the gut wall involved. Serosal involvement is observed in the rarest form that is associated with eosinophilic ascites and dramatic steroid response. A 15-year-old woman with lower abdominal pain visited our hospital. She had a peripheral blood eosinophilia and moderate amount of ascites that is mainly composed of eosinophils. Small bowel series showed diffuse mucosal thickening from the duodenum to the ileum. We diagnosed the case as eosinophilic enteritis with ascites on the basis of clinical, laboratory, radiologic findings. She was treated with corticosteroid and responded rapidly with a complete resolution of ascites and the abdominal pain. (Kor J Gastroenterol 2000;35:507 - 511)

Eosinophilic fasciitis in a patient with polymyositis

( Tae-rim Kim ),( Kihyuk Shin ),( Woo-il Kim ),( Won-ku Lee ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Min-young Yang ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

Eosinophilic fasciitis (EF) is a rare connective tissue disease characterized by erythema and painful edema on extremities, followed by induration of the skin, with laboratory findings of peripheral eosinophilia, hypergammaglobulinemia. Histopathological findings in EF include increased thickness of the fascia with infiltration of lymphocytes, plasma cells, mast cells, eosinophils. The differential diagnosis includes scleroderma, morphea and any panniculitis. A 34-year-old man presented with stiffness of upper extremities for five months. The patient also complained of lesional pain and decreased mobility of the wrist and elbow joint that had occurred a month later. Left forearm MRI showed diffuse fascial T2 hyperintensity with enhancement along the deep and intermuscular fascia. Histopathologic findings revealed thickened fascia with infiltration of eosinophils, lymphocytes and plasma cells, and also showed myopathic change. The patient was diagnosed as EF with polymyositis, based on the clinical characteristics and histopathologic findings. Lesional pain and joint mobility was gradually improved after 10 months of systemic steroid and immunosuppressant. To our knowledge, EF is a rare disease and only 4 cases have been reported in Korean dermatology literature. Moreover, the case of EF with polymyositis has not been reported in Korea before. So we herein report a rare case of EF in a patient with polymyositis.

스테로이드로 치료한 특발성 호산구성 담낭염

강현준 ( Hyun Jun Kang ),최민호 ( Min Ho Choi ),김호태 ( Ho Tae Kim ),곽태영 ( Tae Yeong Kwak ),이현철 ( Hyun Chaol Lee ),김영성 ( Yeong Sung Kim ),곽동협 ( Dong Hyup Kwak ) 대한내과학회 2012 대한내과학회지 Vol.83 No.3

Eosinophilic cholecystitis is a rare disease characterized by transmural leukocyte infiltration composed of more than 90% eosinophils. Eosinophilic cholecystitis is clinically indistinguishable from ordinary cholecystitis, and as a rule it leads to cholecystectomy. We report a case of idiopathic eosinophilic cholecystitis treated with steroids. A 75-year-old woman presented with a classic history of acute cholecystitis and a peripheral eosinophilia of 41.8%. There was no evidence of allergy or parasitic infestation. An abdominal ultrasonography and computed tomography (CT) scan showed an edematous, thickened gallbladder wall, but no gallstones. There was no evidence of eosinophilic infiltration in other organs. Cholecystectomy was not performed because the patient refused surgical management. However, fever, abdominal pain, and peripheral eosinophilia persisted despite antibiotic and conservative therapy. Therefore, we attempted treatment with prednisolone. A week later, the symptoms disappeared and the peripheral eosinophilia normalized.

A Rare Case of Eosinophilic Gastroenteritis in a Neonate with Fever

Minkyeong Lee,최소윤,정미림,이종현,성명순 대한신생아학회 2019 Neonatal medicine Vol.26 No.4

Eosinophilic gastroenteritis is a member of eosinophilic gastrointestinal (GI) diseases and is characterized by the accumulation of eosinophils within the GI tract. Common symptoms of eosinophilic gastroenteritis are vomiting, abdominal pain, dysphagia, and weight loss, but rare fever in neonate. This report describes a 10-day-old boy who developed fever, bloody mucoid stool, and bilious vomiting resulting from eosinophilic gastroenteritis, mimicking sepsis. Sigmoidoscopy and pathologic findings revealed mucosal edema, small hemorrhagic spot, and segmental erythemoid edema in the colon and increased number of eosinophils in the lamina propria with intraepithelial eosinophils. After breast milk feeding with restriction of milk from the mother for 6 months, specific immunoglobulin to milk was class 0 (class 3, previous). The boy restarted formula feeding, and he had no fever and GI symptoms.