Eosinophils in the rectal mucosa. A simple method of predicting the outcome of ulcerative proctocolitis?
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One-hundred-and-thirteen rectal biopsies and 17 total colectomy specimens from 50 patients with ulcerative proctocolitis were examined. These patients had been followed for periods up to 220 months, mean 70 months. The histological changes were compared with the clinical features of the disease. Patients with relatively benign disease which responded to treatment had significantly raised eosinophil counts in the mucosa examined, compared with patients who had aggressive disease which failed to respond to medical treatment (P less than 0.001). Tissue eosinophilia in the rectal mucosa may provide a simple method for predicting the clinical course of patients with ulcerative proctocolitis.Keywords:
Intestinal mucosa
S ummary Inbred rats developed an increased blood eosinophil count 2 weeks after injection of syngeneic or semi‐syngeneic lymphoma cells. An eosinophilia did not occur in allogeneic recipients. Autoradiographic studies of bone marrow eosinophil production showed that additional eosinophils were not being made, and tissue eosinophil levels were also normal. Moreover injections of prednisolone did not lower blood eosinophil counts significantly in the rats with the lymphoma. Other experiments showed that the eosinophilia was probably not due to a graft‐versus‐host reaction. It was concluded that the mechanism of eosinophilia was a prolongation of eosinophil survival in the blood, possibly due to blockage of normal emigration pathways into tissues, by large numbers of blood‐borne lymphoma cells.
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Hematological and genetic characteristics of newly found eosinophilic rats were studied. Hematologically, high blood eosinophil counts started at 6 weeks of age. Almost all 10-week-old rats had eosinophilia with individual counts above 500/microliter and 5 to 100 times the normal level. Proliferating eosinophils had normal morphology. An increase in lymphocyte counts was observed at 5 weeks of age, one week earlier than the onset of eosinophilosis. In bone marrow, proliferation of eosinophils was also observed at 8 weeks of age and thereafter progressed, suggesting a role in the pathogenesis of eosinophilia in this rat. The results of genetic cross experiments revealed the disease to be hereditary. The spontaneously eosinophilic rat therefore warrants attention as a model for studying the underlying mechanisms of human and animal eosinophilia.
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Ancylostoma caninum
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Hypereosinophilic Syndrome
Infiltration (HVAC)
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The eosinophil cells of the blood have been known since Ehrlich, in 1888, introduced differential staining. Eosinophil granulocytes are formed mainly in the bone marrow, and there is probably no relationship between the so-called tissue eosinophilia and eosinophilia in the blood. The physiological variations in the number of circulating eosinophils may be said to have been elucidated, and so are the variations occurring in the eosinophil count in the course of most diseases. On the other hand, little is known about the significance of the eosinophil granules. Although we are in a position to enumerate conditions usually accompanied by eosinopenia and others which have until recently attracted so much attention and are usually accompanied by eosinophilia in the blood, little is known about the regulation of the number of circulating eosinophils. The chemical composition of eosinophilic granules and their function are still unknown. Although a special function can probably be
Eosinopenia
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Twenty-five patients with eosinophil counts > 1,000/mm3 of unknown etiology were treated with albendazole 400 mg twice daily for 7 days were compared with 25 eosinophilic control patients who were not treated. The average eosinophil count in the treated group was 2,079/mm3 (range 1,002-7,629/mm3) and in the control group was 2,047/mm3 (range 1,002-6,468/mm3). One month later the eosinophil counts of both groups were re-evaluated. Effective treatment was defined as an eosinophil count < 1,000/mm3. In the treatment group, 80% had a reduction in the eosinophil count to < 1,000/mm3 while only 12% of the control had a reduction to this level. No side effects were observed in either group. In conclusion, albendazole was found to be highly-effective in the management of patients with eosinophilia without obvious causes.
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Changes in leukocytes and eosinophils in 60 patients with non-infectious attack (NIA patients) were compared with those in 50 patients with infection-related attack (IRA patients). In 30 (50%) of the 60 NIA patients, eosinophilia without leukocytosis was observed on admission, and in 23 (76%) of these 30 patients eosinophilia disappeared within 2 weeks of admission. In 36 (72%) of the 50 IRA patients, leukocytosis without eosinophilia was observed on admission, and the periods from the onset of infection to admission were inversely correlated with leukocyte counts. In 22 eosinophilia patients among the 50 IRA patients, the periods from the onset of infection to admission were correlated with eosinophil counts for up to 40 days, and in 13 (76%) of 17 eosinophilia patients not receiving a long-term steroid therapy during admission, eosinophilia continued for more than 2 weeks even after anti-asthmatic and anti-infectious therapies. There was no significant difference in serum IgE levels between the two groups on admission. These results suggest that evaluations of leukocytes/eosinophils on admission and clinical courses are very useful in the management of asthmatic patients with or without bacterial infections.
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