-
The Journal of Dermatology Mar 2012
Topics: Abscess; Humans; Microscopy, Confocal; Psoriasis; Sensitivity and Specificity
PubMed: 21973117
DOI: 10.1111/j.1346-8138.2011.01366.x -
Allergy and Asthma Proceedings 2012Eosinophilic esophagitis (EoE) is distinguished from gastroesophageal reflux disease (GERD) by persistent esophageal eosinophilia despite medical therapy with... (Review)
Review
Eosinophilic esophagitis (EoE) is distinguished from gastroesophageal reflux disease (GERD) by persistent esophageal eosinophilia despite medical therapy with proton-pump inhibitors for 4-6 weeks. In children, symptoms vary by age groups such as feeding disorders in 2 year olds; vomiting in 8 year olds; and abdominal pain, dysphagia, and/or food impaction in adolescents. Most adults present with dysphagia, food impaction, heartburn or chest pain. Common endoscopic features in adults with EoE include linear furrows (creases that orient longitudinally), mucosal rings (esophageal "trachealization"), small-caliber esophagus, white plaques or exudates (which are microabscesses of eosinophils), and strictures. Children often present with similar endoscopic features, but one-third of pediatric patients with EoE have normal endoscopy. Histological features of EoE include increased intramucosal eosinophils in the esophagus (≥15 eosinophils/high-power field) without similar findings in the stomach or duodenum. There also may be eosinophilic microabscesses. In addition to evidence of mast cell activation, mucosa from patients with EoE have increased IL-5, supporting eosinophilia, and up-regulation of gene expression of eotaxin-3, a chemokine important in eosinophil migration. The majority of patients have evidence of either aeroallergen and/or food sensitization. An elemental/amino acid-based formula diet has shown to be effective in children but may not be well tolerated by adults because of taste and volume or high expense. Topical corticosteroids improve esophageal eosinophilia and symptoms and have become the "gold standard" of pharmacotherapy.
Topics: Adrenal Cortex Hormones; Age Factors; Eosinophilic Esophagitis; Humans
PubMed: 22794699
DOI: 10.2500/aap.2012.33.3559 -
Human Pathology Jul 1979Myocardial infarction complicated by bacterial infection is rare. The present case is an instance in which the infecting organism, Listeria monocytogenes, is also...
Myocardial infarction complicated by bacterial infection is rare. The present case is an instance in which the infecting organism, Listeria monocytogenes, is also rare--an instance not previously reported. The clinical findings were fever without localized infection, severe atherosclerotic heart disease, a myocardial infarct of indeterminate age, and a left ventricular aneurysm. Additional electrocardiographic findings include left bundle branch block, intraventricular conduction defect, and multiple episodes of ventricular tachycardia, all of which may be associated with myocardial infarction and none of which is specific for suppurative myocarditis. Myocardial enzyme abnormalities were absent. Listeria monocytogenes was identified from blood cultures on the day following the patient's death. This case illustrates the difficulty in diagnosing suppurative myocarditis complicating myocardial infarction and the dire consequence of such infection. A review of the literature is included.
Topics: Aged; Humans; Listeria monocytogenes; Listeriosis; Male; Myocardial Infarction; Myocarditis
PubMed: 112029
DOI: 10.1016/s0046-8177(79)80052-0 -
Archives of Pathology & Laboratory... Oct 2007Classical eosinophilic pustular folliculitis, or Ofuji's disease, is a chronic and relapsing dermatosis that is predominantly reported in East Asian populations....
Classical eosinophilic pustular folliculitis, or Ofuji's disease, is a chronic and relapsing dermatosis that is predominantly reported in East Asian populations. Clinically, the disease typically begins as small papules, which enlarge and coalesce into a large plaque, usually on the face. The histopathology is characterized by a prominent eosinophilic infiltrate in the dermis with concentration around pilosebaceous units, often with eosinophilic microabscess formation. The differentiation of eosinophilic pustular folliculitis from other eosinophilic dermatoses is practically challenging and requires close clinicopathologic correlation. Eosinophilic pustular folliculitis may also be associated with human immunodeficiency virus infection, various drugs, and some lymphomas and could also be thought of as a nonspecific dermatopathologic pattern in such settings. The cause of classical eosinophilic pustular folliculitis is unknown, although immune processes are almost certain to play a key role in its pathogenesis.
Topics: Administration, Topical; Diagnosis, Differential; Eosinophilia; Female; Folliculitis; Glucocorticoids; Humans; Male; Sex Factors; Skin Diseases; Suppuration
PubMed: 17922601
DOI: 10.5858/2007-131-1598-EPF -
Annals of Dermatology Apr 2017
PubMed: 28392655
DOI: 10.5021/ad.2017.29.2.229 -
Ocular Immunology and Inflammation Apr 2015We report a case of an immunocompetent woman with atypical marginal keratitis. She presented with recurrent episodes of multiples microabscess distributed in a...
We report a case of an immunocompetent woman with atypical marginal keratitis. She presented with recurrent episodes of multiples microabscess distributed in a triangular pattern associated with stromal oedema and anterior chamber uveitis, affecting both eyes, but not simultaneously. The episodes responded to steroid drops, corneal inflammation was coincidental with a worsening of her blepharitis in the affected eye and S. aureus was isolated from the lids.
Topics: Abscess; Blepharitis; Corneal Stroma; Eye Infections, Bacterial; Female; Humans; Keratitis; Middle Aged; Staphylococcal Infections; Staphylococcus aureus; Uveitis
PubMed: 24410378
DOI: 10.3109/09273948.2013.870214 -
Comprehensive Physiology Dec 2015The importance of homocysteine in vascular function and arteriosclerosis was discovered by demonstration of arteriosclerotic plaques in children with homocystinuria... (Review)
Review
The importance of homocysteine in vascular function and arteriosclerosis was discovered by demonstration of arteriosclerotic plaques in children with homocystinuria caused by inherited enzymatic deficiencies of cystathionine synthase, methionine synthase, or methylene-tetrahydrofolate reductase. According to the homocysteine theory of arteriosclerosis, an elevated blood homocysteine level is an important risk factor for atherosclerosis in subjects without these rare enzymatic abnormalities. The homocysteine theory is supported by demonstration of arterial plaques in experimental animals with hyperhomocysteinemia, by discovery of a pathway for conversion of homocysteine thiolactone to sulfate in cell cultures from children with homocystinuria, and by demonstration of growth promotion by homocysteic acid in normal and hypophysectomized animals. Studies with cultured malignant cells revealed abnormal homocysteine thiolactone metabolism, resulting in homocysteinylation of proteins, nucleic acids, and glycosaminoglycans, explaining the abnormal oxidative metabolism, abnormalities of cellular membranes, and altered genetic expression observed in malignancy. Abnormal homocysteine metabolism in malignant cells is attributed to deficiency of thioretinamide, the amide synthesized from retinoic acid and homocysteine thiolactone. Two molecules of thioretinamide combine with cobalamin to form thioretinaco. Based on the molecular structure of thioretinaco, a theory of oxidative phosphorylation was proposed, involving oxidation to a disulfonium derivative by ozone, and binding of oxygen, nicotinamide adenine dinucleotide and phosphate as the active site of adenosine triphosphate synthesis in mitochondria. Obstruction of vasa vasorum by aggregates of microorganisms with homocysteinylated low-density lipoproteins is proposed to cause ischemia of arterial wall and a microabscess of the intima, the vulnerable atherosclerotic plaque.
Topics: Aging; Animals; Atherosclerosis; Homocysteine; Humans
PubMed: 26756640
DOI: 10.1002/cphy.c150021 -
Seminars in Diagnostic Pathology Aug 2002This study discusses the differential diagnosis of atypical postinfectious glomerulonephritis (PIGN) which may mimic a great variety of glomerular diseases. These... (Review)
Review
This study discusses the differential diagnosis of atypical postinfectious glomerulonephritis (PIGN) which may mimic a great variety of glomerular diseases. These include mild mesangial and/or endocapillary glomerulonephritis (GN) focal segmental glomerulosclerosis (FSGS) with diffuse IgM mesangial deposits, crescentic GN with C3 hump-like deposits, focal mesangiocapillary GN superimposed on endocapillary pattern, membranous GN with diffuse exudative changes, crescentic GN with microabscesses, and postinfectious glomerulonephritis with anti-GBM linear deposits.
Topics: Antigen-Antibody Complex; Capillaries; Diagnosis, Differential; Glomerular Mesangium; Glomerulonephritis; Glomerulonephritis, Membranoproliferative; Glomerulonephritis, Membranous; Glomerulosclerosis, Focal Segmental; Humans; Infections; Kidney Glomerulus; Virus Diseases
PubMed: 12180635
DOI: No ID Found -
Journal of Periodontology Jul 2007This article recognizes the microscopic diagnosis of acute spongiotic mucositis as an analog to acute spongiotic dermatitis of the skin and defines a specific...
BACKGROUND
This article recognizes the microscopic diagnosis of acute spongiotic mucositis as an analog to acute spongiotic dermatitis of the skin and defines a specific clinicopathological entity "juvenile spongiotic gingivitis" within this microscopic spectrum.
METHODS
Twenty-four patients, usually juveniles, with patches of bright red, often slightly thickened, painless, and persistent lesions of the attached gingiva, which may or may not involve the marginal gingiva, were identified by clinical and microscopic features. Immunohistochemical studies for cytokeratins 5/6 and 19, estrogen receptors, and progesterone receptors were completed on 10 of these cases. A comparison to puberty gingivitis, which occurs in the same age group, was done.
RESULTS
Microscopically, the epithelium exhibited hyperplasia, significant spongiosis, loss of keratinization, and a neutrophilic infiltrate, sometimes with microabscess formation, whereas the underlying connective tissue exhibited an acute on chronic inflammatory infiltrate. Full-thickness epithelial immunostaining for cytokeratins 5/6 and 19 was found, whereas no reactivity was seen for estrogen receptors or progesterone receptors in the specimens.
CONCLUSIONS
Juvenile spongiotic gingivitis differs from puberty gingivitis by not needing to show continuity with plaque-related marginal gingivitis, by a lack of response to hygiene procedures, by an occasional occurrence at ages not related to puberty, and by the absence of sex hormone receptors investigated immunohistochemically in 10 of the cases. We propose juvenile spongiotic gingivitis as a distinct clinicopathological entity.
Topics: Adolescent; Adult; Age Factors; Child; Child, Preschool; Dental Plaque; Diagnosis, Differential; Edema; Epithelium; Female; Gingiva; Gingivitis; Humans; Male
PubMed: 17608578
DOI: 10.1902/jop.2007.060502 -
American Journal of Clinical Pathology Jun 2004Cat-scratch disease (CSD) initially was described in 1931, but the etiologic agent (Bartonella henselae) was not elucidated until decades later. This disease is the most... (Review)
Review
Cat-scratch disease (CSD) initially was described in 1931, but the etiologic agent (Bartonella henselae) was not elucidated until decades later. This disease is the most common cause of chronic lymphadenopathy among children and adolescents, characteristically manifesting as subacute regional lymphadenitis with an associated inoculation site due to a cat scratch or bite, often accompanied by fever. The hallmark histologic lesion is granulomatous inflammation with a central stellate microabscess. Numerous atypical manifestations of CSD have been described, and these often lack the characteristic superficial lymphadenopathy and inoculation site papule. These atypical forms may be misdiagnosed initially as other infectious processes or neoplasms. We present a review of the history and epidemiologic features of CSD, describe common and unusual clinicopathologic manifestations, and discuss current diagnostic modalities.
Topics: Animals; Cat-Scratch Disease; Cats; Humans
PubMed: 15298152
DOI: 10.1309/JC8YM53L4E0L6PT5