scholarly journals Eosinophil Counts in Mucosal Biopsies of the Ileum and Colon: Interobserver Variance Affects Diagnostic Accuracy

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Florian Hentschel ◽  
Anna Franziska Jansen ◽  
Marlis Günther ◽  
Roland Pauli ◽  
Stefan Lüth
Keyword(s):  
Staining Method ◽  
Sampling Site ◽  
Eosinophilic Gastroenteritis ◽  
Rare Entity ◽  
Endoscopic Findings ◽  
Slide Preparation ◽  
Microscopic Field ◽  
Histopathologic Findings ◽  
Very High ◽  
Eosinophil Counts

Primary eosinophilic gastroenteritis and colitis (EGE) is a rare entity with unspecific clinical and endoscopic findings. Validated histopathologic criteria for confirming the diagnosis are lacking, because numeric values for normal or elevated concentrations of eosinophils in mucosal biopsies are varying between observers. To quantify this interobserver variance, we had the same set of 30 slides of eosinophilic-rich mucosal biopsies from the ileum and colon systematically reviewed by a panel of six independent pathologists, each with more than a ten-year experience in the field. Using a highly standardized biopsy and slide preparation protocol, we ruled out any influence by the preparation, the patient, the endoscopist, the endoscopes and calipers used, the sampling site, the fixation and staining method, and the microscopic field sizes. Still, all numeric results differed between pathologists up to a factor greater than 30. Calculated positive or negative diagnosis of EGE differed up to a factor greater than 8. A theoretical incidence for EGE calculated from these numbers differed by a factor greater than 1500. We conclude that eosinophil counts in mucosal biopsies from the lower gastrointestinal tract are subject to a very high interobserver variance. Until further research provides objective and validated methods for standardization, all epidemiologic numbers derived from histopathologic findings may have to be questioned. When diagnosing individual patients with EGE, overall morphologic picture together with clinical and endoscopic findings is more important than numeric eosinophil count.

UNEXPLAINED DELIRIUM : THINK OF THYROID STORM

2021 ◽  
pp. 23-25
Author(s):  
Soni Namita ◽  
Shruti A ◽  
Soni Anand ◽  
Nikalje A ◽  
Bharadwaj M
Keyword(s):  
Ventricular Tachycardia ◽  
Thyroid Storm ◽  
Rare Entity ◽  
Thyroid Medication ◽  
Malignant Arrhythmia ◽  
Life Threatening ◽  
Systemic Condition ◽  
Very High ◽  
Serum Tsh

Background: Thyroid storm is a life-threatening Endocrine emergency with an incidence rate of 1% to 2% all over the world. It is a systemic condition leading to increased production of Thyroid Hormone and its release leading to Thermoregulatory, Adrenergic, Neuropsychiatric, Cardiovascular, and Abdominal Manifestations. Thyroid storm with Malignant Arrhythmia and delirium both together is rare entity, but the mortality rate is very high. The presentation of Malignant Arrhythmias and delirium together in the initial phase of the disease is much less common with only a few isolated cases described in the scientic literature. Objective: To present a case in which a patient had two simultaneous complication of thyroid storm i.e. delirium and ventricular tachycardia. Case Study: We report a 65 years-year-old man who came with complaints of Diarrhea, Fever, Breathlessness and psychosis. His serum tsh was <0.015 and anti tpo antibodies was 83. He was diagnosed to be in Thyroid storm and later had complications including Ventricular Tachycardia and delirium in an undiagnosed case of Hyperthyroidism. He was started on anti thyroid medication and slowly as his condition improved he was discharged. Conclusion: Patients with Thyrotoxicosis need to be closely monitored for complications since its early diagnosis and treatment may save lives.

scholarly journals Endoscopic findings of gastric lesions in patients with eosinophilic gastrointestinal disorders

2020 ◽  
Vol 08 (12) ◽  
pp. E1817-E1825
Author(s):  
Yasuhiro Fujiwara ◽  
Kojiro Tanoue ◽  
Akira Higashimori ◽  
Yu Nishida ◽  
Masatsugu Maruyama ◽  
...  
Keyword(s):  
Eosinophilic Esophagitis ◽  
Submucosal Tumor ◽  
Eosinophilic Gastroenteritis ◽  
Gastrointestinal Disorders ◽  
Gastric Lesions ◽  
Pyloric Ring ◽  
Eosinophilic Colitis ◽  
Endoscopic Findings ◽  
Eosinophilic Gastritis ◽  
Eosinophilic Gastrointestinal Disorders

Abstract Background and study aims Eosinophilic gastrointestinal disorders are classified into eosinophilic esophagitis, eosinophilic gastritis, eosinophilic gastroenteritis, and eosinophilic colitis according to the site of eosinophilic infiltration. Although well established in eosinophilic esophagitis, endoscopic findings in eosinophilic gastritis and eosinophilic gastroenteritis with regard to gastric lesions have not been clearly described. The aim of this study was to identify endoscopic findings of gastric lesions associated with eosinophilic gastrointestinal disorders. Patients and methods Out of 278 patients with eosinophilic gastrointestinal disorders, 18 had eosinophilic gastritis or eosinophilic gastroenteritis confirmed by biopsy; their endoscopic images were analyzed retrospectively. The association between endoscopic findings and number of eosinophils in the gastric mucosa was investigated. Results Erythema was most frequently observed (72 %), followed by ulcers (39 %), discoloration (33 %), erosions (28 %), nodularity (28 %), and polyps (28 %). There were several unique endoscopic findings such as submucosal tumor-like deep large ulcers in three patients, antral Penthorum-like appearances (small nodules radially lined toward the pyloric ring) in three patients, “muskmelon-like appearances” (discolored mucosa-composed mesh pattern) in three patients, multiple white granular elevations in two patients, cracks (appearance of furrows similar to those in eosinophilic esophagitis) in five patients, and antral rings in one patient. No significant association was observed between endoscopic findings and number of gastric eosinophils. Conclusions Several unique endoscopic findings of gastric lesions were observed in patients with eosinophilic gastritis or eosinophilic gastroenteritis. Submucosal tumor-like ulcers, antral Penthorum-like appearances, muskmelon-like appearances, and cracks might be associated with eosinophilic gastrointestinal disorders.

Invasive Fungal Sinusitis in the Immunocompromised Pediatric Patient

1995 ◽  
Vol 74 (8) ◽  
pp. 566-573 ◽  
Author(s):  
Bryan K. Lansford ◽  
Charles M. Bower ◽  
Robert W. Seibert
Keyword(s):  
Pediatric Population ◽  
Treatment Protocol ◽  
Underlying Disease ◽  
Antineoplastic Drugs ◽  
Fungal Sinusitis ◽  
Rare Entity ◽  
Review Of The Literature ◽  
Presenting Symptoms ◽  
Invasive Fungal Sinusitis ◽  
Histopathologic Findings

Invasive fungal sinusitis in the pediatric population appears to be a relatively rare entity. An increasing incidence has been noted in accordance with the widespread use of antibiotics, steroids, antineoplastic drugs and radiation therapy. Three illustrative cases are described which outline the initial presenting symptoms, findings on physical examination, computed tomography (CT), intraoperative findings, and histopathologic findings. A review of the literature is presented and a treatment protocol is proposed once a diagnosis is made. Early suspicion and diagnosis are the most important prerequisites for successful treatment which consists of control of the underlying disease, surgical debridement, and systemic antifungal therapy. Cooperation between the otolaryngologist, pediatric specialists, and pathologists are key to the survival of children with invasive fungal sinusitis. Survival in this series was dependent upon return of an immune competent state.

Angioma Serpiginosum with Linear Distribution: Case Report and Review of the Literature

2008 ◽  
Vol 12 (4) ◽  
pp. 180-183 ◽  
Author(s):  
Mike S. Kalisiak ◽  
Richard M. Haber
Keyword(s):  
Case Report ◽  
Vascular Anomaly ◽  
Rare Entity ◽  
Review Of The Literature ◽  
Linear Distribution ◽  
Delayed Treatment ◽  
Skin Biopsies ◽  
The Common ◽  
The Right ◽  
Histopathologic Findings

Background: Angioma serpiginosum is a vascular anomaly that classically presents in childhood and predominantly affects females. Objective: To present a case of a young woman with linear distribution of angioma serpiginosum and review the common clinical characteristics and presentation of this condition. Methods: Case report with skin biopsies and dermoscopic findings. Results: A clinical examination revealed numerous irregular punctate red macules in a linear distribution over the right arm. On dermoscopy, the lesions appeared as multiple sharply demarcated red lagoons. The histopathologic findings of dilated blood vessels in the papillary dermis with absence of other changes confirmed the diagnosis of angioma serpiginosum. Conclusion: Angioma serpiginosum is a rare entity that can be distinguished by clinical and histopathologic examinations. Lack of recognition of this condition may lead to unnecessary investigations and delayed treatment.

scholarly journals Fundamental aspects of the interaction of propidium diiodide with nuclei acids studied in a model system of polyacrylamide films.

1981 ◽  
Vol 29 (8) ◽  
pp. 929-936 ◽  
Author(s):  
J Tas ◽  
G Westerneng
Keyword(s):  
Staining Method ◽  
Model System ◽  
Appreciable Amount ◽  
Optimal Conditions ◽  
Binding Ability ◽  
Qualitative And Quantitative ◽  
Dna And Rna ◽  
Linear Relationships ◽  
The Stability ◽  
Very High

Qualitative and quantitative aspects of the fluorescent propidium diiodide (PI) staining method have been investigated with model films of polyacrylamide gel incorporated with DNA, RNA, and other macromolecular compounds. PI was found to bind specifically to DNA and RNA, most probably by intercalation into double-stranded regions. Proteins, glycogen, and glycosaminoglycans did not show fluorescence after PI staining. Optimal conditions for dye binding and differentiation have been defined. The stability of nucleic acid-PI complexes, as present in model films, was shown to be very high in distilled water, while dissociation rapidly occurred in ionic media. Linear relationships were found between the fluorescence intensity of bound PI and both the thickness of the model films and the amount of DNA or RNA incorporated. The presence of histone protein bound ionically to DNA did not influence the fluorescent PI binding ability in any appreciable amount.

scholarly journals The rare association of leukoencephalopathy, cerebral calcifications, and cysts: case report

2010 ◽  
Vol 16 (3) ◽  
pp. 115-117
Author(s):  
Gustavo Rassier Isolan ◽  
Lucas Scotta Cabral ◽  
Cláudio Galvão de Castro Júnior ◽  
Ápio Cláudio Antunes ◽  
Gilberto Schwartsmann ◽  
...  
Keyword(s):  
Case Report ◽  
Basal Ganglia ◽  
Rare Entity ◽  
Rare Association ◽  
Cerebral Calcifications ◽  
Long Time ◽  
Histopathologic Findings

Although basal ganglia calcifications were described a long time ago,1,3,11 the association of leukoencephalopathy, cerebral calcifications, and cysts (LCC) is a very rare entity described in 1996.5 We present a new case of LCC and discuss clinical, neuroradiologic, and histopathologic findings regarding this association.

scholarly journals Morphology, Protein Profile and the Level of Infestation of Bedbugs (Hempitera: Cimicidae) in the Halls of Residence of a Higher Institution in Lagos.

2019 ◽  
Vol 1 ◽  
pp. 96-104
Author(s):  
K A Kemabonta ◽  
M O Ajiboye
Keyword(s):  
Staining Method ◽  
Profile Analysis ◽  
Protein Profile ◽  
Polyacrylamide Gel Electrophoresis ◽  
Morphological Characterization ◽  
Sds Page ◽  
Higher Institution ◽  
Cimex Hemipterus ◽  
Very High

Morphology, protein profile and the level of Bedbug infestations were carried out at a University in Lagos, Nigeria after an outcry of high infestation by the students in halls of residence. Three bedbugswere each collected from nine halls of residence for morphological characterization of adults and to carry out protein profile analysis usingSodium Dodecyl Sulfate Polyacrylamide Gel Electrophoresis (SDS-PAGE) and Coomassie staining method. Level of infestation of Bedbugs was carried out in two female halls A and Busing blood smeared on the walls. All bedbugs found were Cimex hemipterus. 29.8% of the rooms in Hall Bhad no bedbug infestation, 23.9%, 20.2%, 15.4% and 10.6% had low, average, high and very high levels of bedbug infestation respectively while in A hall, it was 21.4%, 30.5%, 24.4%, 14.5% and 9.2% respectively. In A hall, 4.6%, 16.8% and 0.8% had one, two and three out of the four mattresses in the room infested with bedbugs respectively while 56.5% had all the four mattresses infested with bedbugs. In B hall, 1.6%, 16.0% and 0% had one, two and three mattresses infested with bedbugs respectively while the remaining 52.7% had all the four mattresses in the room infested with bedbugs. There was a significant relationship between the level of infestation and the number of mattresses infested in each hall (P < 0.01).The protein profile analysis of bedbugs did not show the protein bands clearly because of the low soluble protein content of Cimex hemipterus and the detection limit of Coomassie stain.

Eosinophilic colitis: an infrequent disease with difficult diagnose

2020 ◽  
Vol 13 (9) ◽  
pp. e235804
Author(s):  
Javier Páramo-Zunzunegui ◽  
Ignacio Ortega-Fernandez ◽  
Silvia Benito-Barbero ◽  
Laura Rubio-López
Keyword(s):  
Normal Mucosa ◽  
Eosinophilic Gastroenteritis ◽  
Steroid Treatment ◽  
Inflammatory Disorder ◽  
Rare Entity ◽  
Colon Wall ◽  
Population Impact ◽  
Eosinophilic Colitis ◽  
Eosinophilic Infiltrate ◽  
Bowel Movements

Eosinophilic colitis (EC) is a rare entity. It is part of eosinophilic gastroenteritis, a rare inflammatory disorder characterised by eosinophilic infiltration of tissues that can affect any segment of the digestive tract. The diagnosis is established by the presence of an increased eosinophilic infiltrate in the colon wall in symptomatic patients. There is no characteristic clinical picture of EC. It can be associated with abdominal pain, changes in bowel movements, diarrhoea and rectal bleeding. Biopsies are mandatory if EC is suspected and despite visualising a normal mucosa. Although there are no protocol guidelines in this regard, steroid treatment is the first option in controlling the disease. Increasing the knowledge of clinicians and pathologists of this disorder and the recording its real incidence and population impact, could improve the understanding and treatment of the disease.

scholarly journals Uncommon Endoscopic Findings in a Tylosis Patient: A Case Report

2019 ◽  
Vol 12 (2) ◽  
pp. 385-390
Author(s):  
Balarama K. Surapaneni ◽  
Pragnan Kancharla ◽  
R. Vinayek ◽  
Sudhir K. Dutta ◽  
Mendel Goldfinger
Keyword(s):  
Disease Process ◽  
Beta Carotene ◽  
Carcinoma Of The Esophagus ◽  
Endoscopic Findings ◽  
Complete Penetrance ◽  
Palmoplantar Hyperkeratosis ◽  
Screening Protocol ◽  
Mucosal Changes ◽  
Surveillance Endoscopy ◽  
Very High

Palmoplantar tylosis is a focal non epidermolytic palmoplantar hyperkeratosis and is associated with a very high lifetime risk of developing squamous cell carcinoma of the esophagus (OSCC). It is generally inherited as an autosomal dominant trait with complete penetrance involving the RHBDF2 gene located on 17q25.1. The data regarding endoscopic appearance of the mucosa in patients with tylosis before development of cancer is limited. Surveillance endoscopy is recommended in family members which include annual esophagogastroscopy with biopsy of suspicious lesion with quadratic biopsies from upper, middle and lower esophagus. We describe characteristic endoscopy findings in a tylosis with no evidence of cancer. Prospective documentation of endoscopic findings of similar mucosal changes and disease process to establish a better screening protocol and supplemental intervention with agents like carotenoids (beta-carotene, alpha-carotene, lycopene, beta-cryptoxanthin, lutein, and zeaxanthin) may delay the progression and possibly revert to normal.

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