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Discrepant serum and urine β-hCG results due to production of β-hCG by a cribriform-morular variant of thyroid papillary carcinoma. Clin Chim Acta 2014; 438:181-5. [PMID: 25181612 DOI: 10.1016/j.cca.2014.08.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 08/21/2014] [Accepted: 08/22/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND Although patients with medullary thyroid cancer are known to present with paraneoplastic hormone production, this is much less common with papillary thyroid cancer. METHODS We present a patient with the cribriform morular variant of papillary thyroid cancer in association with familial adenomatous polyposis who developed a positive pregnancy test in the absence of known pregnancy. The patient had developed vaginal bleeding, and her laboratory testing was characterized by elevated serum human chorionic gonadotropin (β-hCG) concentrations, but negative qualitative urine results. After a thorough gynecological evaluation to exclude unexpected normal, ectopic, or molar pregnancy, we pursued an evaluation for other sources of β-hCG production. RESULTS We showed that the elevated serum β-hCG concentrations were not the result of heterophile antibody interferences, and ultimately we proved that her recurrent tumor produced the ectopic β-hCG. This is the first report of β-hCG production by papillary thyroid cancer. Thus, the possibility of ectopic production of β-hCG by papillary thyroid cancer needs to be included in the differential diagnosis of elevated hCG concentration in the absence of pregnancy. CONCLUSIONS This study of an unusual paraneoplastic syndrome highlights the importance of investigating discrepancies in the clinical laboratory.
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2
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Kang K, Park JH, Ryu JY, Lee SY, Ko GJ, Kwon YJ. Acute pyelonephritis with anaplastic thyroid carcinoma producing granulocyte colony-stimulating factor. Blood Res 2013; 48:63-6. [PMID: 23589799 PMCID: PMC3625010 DOI: 10.5045/br.2013.48.1.63] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Revised: 06/22/2012] [Accepted: 02/04/2013] [Indexed: 11/17/2022] Open
Abstract
Paraneoplastic leukocytosis was defined as elevated white blood cell (WBC) levels caused by cytokines, likely produced by the tumor itself, without evidence of infection or myeloproliferative disease. We report a case of anaplastic thyroid carcinoma with leukocytosis caused by elevated production of granulocyte colony-stimulating factor (G-CSF) by the carcinoma. Initially, acute pyelonephritis (APN) was diagnosed and treatment for APN was ongoing, but the WBC count steadily increased to 68.8×10(9)/L. She was diagnosed with anaplastic thyroid carcinoma on her neck mass, and the serum concentration of G-CSF was found to be markedly increased at 1,010 pg/mL. In spite of supportive care, the patient's condition rapidly deteriorated and the patient died on day 23 of hospital stay. Leukocytosis without definite evidence of infection could be a paraneoplastic manifestation in patients with malignant tumors, and paraneoplastic leukocytosis may be related to poor prognosis.
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Affiliation(s)
- Keunhee Kang
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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3
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Todenhöfer T, Wirths S, von Weyhern CH, Heckl S, Horger M, Hennenlotter J, Stenzl A, Kanz L, Schwentner C. Severe paraneoplastic hypereosinophilia in metastatic renal cell carcinoma. BMC Urol 2012; 12:7. [PMID: 22436420 PMCID: PMC3348004 DOI: 10.1186/1471-2490-12-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Accepted: 03/21/2012] [Indexed: 02/08/2023] Open
Abstract
Background Renal cell carcinoma can cause various paraneoplastic syndromes including metabolic and hematologic disturbances. Paraneoplastic hypereosinophilia has been reported in a variety of hematologic and solid tumors. We present the first case in the literature of severe paraneoplastic hypereosinophilia in a patient with renal cell carcinoma. Case presentation A 46 year-old patient patient with a history of significant weight loss, reduced general state of health and coughing underwent radical nephrectomy for metastasized renal cell carcinoma. Three weeks after surgery, the patient presented with excessive peripheral hypereosinophilia leading to profound neurological symptoms due to cerebral microinfarction. Systemic treatment with prednisolone, hydroxyurea, vincristine, cytarabine, temsirolimus and sunitinib led to reduction of peripheral eosinophils but could not prevent rapid disease progression of the patient. At time of severe leukocytosis, a considerable increase of cytokines associated with hypereosinophilia was measurable. Conclusions Paraneoplastic hypereosinophilia in patients with renal cell carcinoma might indicate poor prognosis and rapid disease progression. Myelosuppressive therapy is required in symptomatic patients.
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Affiliation(s)
- Tilman Todenhöfer
- Department of Urology, University Hospital Tuebingen, Tuebingen, Germany
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4
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Camargos EF, Pandolfi MB, Toledo MAV, Quintas JL, Moreira S, de Azevedo AEB, Tavares AC. A 95-year-old woman with leucocytosis and eosinophilia: anaplastic carcinoma in an ectopic thyroid. BMJ Case Rep 2010; 2010:2823. [PMID: 22767520 DOI: 10.1136/bcr.03.2010.2823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 95-year-old woman had been treated over the past 8 years for progressive dysphagia. When her condition worsened, blood tests revealed the presence of leucocytosis and eosinophilia in the absence of anaemia or thrombocytopenia. Within 11 days of diagnosis, the patient died of respiratory failure. Necropsy showed normal thyroid tissue and an absence of infectious disease. However, an upper mediastinal tumour was found and was histopathologically diagnosed as a neoplastic transformation of the ectopic thyroid. Only 1% of endothoracic goitres present as ectopic or autonomous goitre with no parenchymal or vascular connection to the thyroid gland. This case represents a very rare situation in which a leukemoid reaction and peripheral hypereosinophilia were observed as a manifestation of an anaplastic thyroid carcinoma in an ectopic mass.
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5
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Matsuzaki M, Shimamoto Y, Enokihara H, Yamaguchi M. High Eo-CSF activity in T-cell non-Hodgkin's lymphoma with eosinophilia. CLINICAL AND LABORATORY HAEMATOLOGY 2008; 14:251-5. [PMID: 1451405 DOI: 10.1111/j.1365-2257.1992.tb00372.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- M Matsuzaki
- Department of Internal Medicine, Saga Medical School, Japan
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6
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Ames PRJ, Aye WW. Pleural mesothelioma and venous thrombosis: the eosinophilia link. Thromb J 2008; 6:3. [PMID: 18442410 PMCID: PMC2390511 DOI: 10.1186/1477-9560-6-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2007] [Accepted: 04/28/2008] [Indexed: 11/10/2022] Open
Abstract
Peripheral blood eosinophilia and vascular occlusions are rare occurrences in patients with pleural mesothelioma whereas eosinophilia may associate with thrombosis. We describe a patient with mesothelioma who developed peripheral blood eosinophilia followed by deep vein thrombosis despite being on low molecular weight heparin prophylaxis. We discuss the genesis of peripheral blood eosinophilia and thrombosis in pleural mesothelioma.
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7
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Haghpanah V, Lashkari A, Tavangar SM, Moradzadeh K. Hypereosinophilia as the presentation of metastatic medullary thyroid carcinoma: a remarkable event. Am J Med Sci 2007; 334:131-2. [PMID: 17700204 DOI: 10.1097/maj.0b013e31812e872f] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Hypereosinophilic syndrome is a rare disorder characterized by persistent eosinophilia combined with organ system dysfunction. This report is of a 37-year-old man who had eosinophilia, periodic fever, weight loss, and generalized bone pain. A small nodule in left lobe of thyroid was detected in his physical examination. The patient underwent surgery and histopathological study, which confirmed that the patient had medullary carcinoma of thyroid. The patient died 6 months after the surgery. Eosinophilia is more commonly seen with benign conditions. However, less frequent but malignant etiologies always should be contemplated.
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Affiliation(s)
- Vahid Haghpanah
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
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8
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Abstract
Blood eosinophilia signifies either a cytokine-mediated reactive phenomenon (secondary) or an integral phenotype of an underlying haematological neoplasm (primary). Secondary eosinophilia is usually associated with parasitosis in Third World countries and allergic conditions in the West. Primary eosinophilia is operationally classified as being clonal or idiopathic, depending on the respective presence or absence of a molecular, cytogenetic or histological evidence for a myeloid malignancy. The current communication features a comprehensive clinical summary of both secondary and primary eosinophilic disorders with emphasis on recent developments in molecular pathogenesis and treatment.
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Affiliation(s)
- Ayalew Tefferi
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
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9
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Fujita T, Ogasawara Y, Naito M, Doihara H, Shimizu N. Anaplastic Thyroid Carcinoma Associated with Granulocyte Colony-Stimulating Factor: Report of a Case. Surg Today 2005; 36:63-7. [PMID: 16378196 DOI: 10.1007/s00595-005-3100-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2004] [Accepted: 05/24/2005] [Indexed: 10/25/2022]
Abstract
A 75-year-old woman was hospitalized due to a right axillary mass. She had undergone a resection of thyroid carcinoma 13 years earlier, followed by two subsequent operations for recurrent thyroid disease. A physical examination revealed a right axillary mass associated with skin ulceration. Persistent bleeding was observed at the skin ulcer associated with the right axillary lymph node, despite conservative treatment for the lesion. Surgery was thus performed to control persistent bleeding from the axillary ulcer, and a histopathological examination resulted in a diagnosis of poorly differentiated thyroid carcinoma. The postoperative course was uneventful, but marked leukocytosis and extensive skin metastases were recognized 30 days postoperatively. A systemic examination revealed no other lesions associated with marked leukocytosis, but elevated levels of granulocyte colony-stimulating factor were noted in a blood examination. As a result, her general condition deteriorated rapidly and the patient died 2 weeks after the onset of leukocytosis.
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Affiliation(s)
- Takeo Fujita
- Department of Cancer and Thoracic Surgery, Okayama University Graduate School of Medicine and Dentistry, 2-5-1 Shikata-cho, Okayama 700-8558, Japan
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10
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Abstract
Acquired blood eosinophilia is considered either a primary or a secondary phenomenon. Causes of secondary (ie, reactive) eosinophilia include tissue-invasive parasitosis, allergic or inflammatory conditions, and malignancies in which eosinophils are not considered part of the neoplastic process. Primary eosinophilia is classified operationally into 2 categories: clonal and idiopathic. Clonal eosinophilia stipulates the presence of either cytogenetic evidence or bone marrow histological evidence of an otherwise classified hematologic malignancy such as acute leukemia or a chronic myeloid disorder. Idiopathic eosinophilia is a diagnosis of exclusion (ie, not secondary or clonal). Hypereosinophilic syndrome is a subcategory of idiopathic eosinophilia; diagnosis requires documentation of both sustained eosinophilia (absolute eosinophil count > or = 1500 cells/microL for at least 6 months) and target organ damage (eg, involvement of the heart, lung, skin, or nerve tissue). Genetic mutations involving the platelet-derived growth factor receptor genes (PDGFR-alpha and PDGFR-beta) have been pathogenetically linked to clonal eosinophilia, and their presence predicts treatment response to imatinib. Accordingly, cytogenetic and/or molecular investigations for the presence of an imatinib-sensitive molecular target should accompany current evaluation for primary eosinophilia. In the absence of such a drug target, specific treatment is dictated by the underlying hematologic malignancy in cases of clonal eosinophilia; however, the initial treatment of choice for symptomatic patients with hypereosinophilic syndrome is prednisone and/or interferon alfa.
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Affiliation(s)
- Ayalew Tefferi
- Department of Internal Medicine and Division of Hematology, Mayo Clinic College of Medicine, Rochester, Minn 55905, USA.
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11
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Abstract
Acquired blood eosinophilia is considered either a primary or a secondary phenomenon. Causes of secondary (ie, reactive) eosinophilia include tissue-invasive parasitosis, allergic or inflammatory conditions, and malignancies in which eosinophils are not considered part of the neoplastic process. Primary eosinophilia is classified operationally into 2 categories: clonal and idiopathic. Clonal eosinophilia stipulates the presence of either cytogenetic evidence or bone marrow histological evidence of an otherwise classified hematologic malignancy such as acute leukemia or a chronic myeloid disorder. Idiopathic eosinophilia is a diagnosis of exclusion (ie, not secondary or clonal). Hypereosinophilic syndrome is a subcategory of idiopathic eosinophilia; diagnosis requires documentation of both sustained eosinophilia (absolute eosinophil count > or = 1500 cells/microL for at least 6 months) and target organ damage (eg, involvement of the heart, lung, skin, or nerve tissue). Genetic mutations involving the platelet-derived growth factor receptor genes (PDGFR-alpha and PDGFR-beta) have been pathogenetically linked to clonal eosinophilia, and their presence predicts treatment response to imatinib. Accordingly, cytogenetic and/or molecular investigations for the presence of an imatinib-sensitive molecular target should accompany current evaluation for primary eosinophilia. In the absence of such a drug target, specific treatment is dictated by the underlying hematologic malignancy in cases of clonal eosinophilia; however, the initial treatment of choice for symptomatic patients with hypereosinophilic syndrome is prednisone and/or interferon alfa.
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Affiliation(s)
- Ayalew Tefferi
- Department of Internal Medicine and Division of Hematology, Mayo Clinic College of Medicine, Rochester, Minn 55905, USA.
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12
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Ionescu MA, Rivet J, Daneshpouy M, Briere J, Morel P, Janin A. In situ eosinophil activation in 26 primary cutaneous T-cell lymphomas with blood eosinophilia. J Am Acad Dermatol 2005; 52:32-9. [PMID: 15627078 DOI: 10.1016/j.jaad.2004.03.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Blood and tissue eosinophils can be associated with Hodgkin and non-Hodgkin lymphomas in that they have prognostic value. Tissue eosinophils in T-cell lymphoma patients with blood eosinophilia have not been systematically assessed. The objective of this research was to study the presence, density, and activation of tissue eosinophils in patients with primary cutaneous T-cell lymphomas (CTCLs) with blood eosinophilia and a possible relationship between features of the disease and prognosis. With skin biopsy specimens from 26 CTCL patients with blood eosinophilia, tissue eosinophils were studied with electron microscopy, extracellular eosinophil peroxidase deposits, and interleukin-5 expression. Tissue eosinophils, found in 22 of 26 cases, were constantly activated. Both density and activation of tissue eosinophils were significantly related to disease progression. The state of activation of tissue eosinophils in CTCL might reflect inflammatory flare-ups associated with aggressive lymphomas. Further studies are needed to confirm the value of eosinophil density as a simple and reliable marker of CTCL progression.
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Affiliation(s)
- Marius A Ionescu
- Department of Dermatology, ERM 0220 INSERM/Hematology Institute IFR 105, Saint-Louis Hospital University Paris VII, France
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13
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Sul HR, Kim SJ, Kim DI, Kim SG, Choi DS, Jo YJ, Kim BS. Peripheral Blood Eosinophilia: An Unusual Presentation of Bone Marrow Involvement in a Patient with Relapsed Thyroid Papillary Carcinoma. THE KOREAN JOURNAL OF HEMATOLOGY 2005. [DOI: 10.5045/kjh.2005.40.4.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Hye Ryoung Sul
- Department of Internal Medicine, Korea University Medical Center, Seoul, Korea
| | - Seok Jin Kim
- Department of Internal Medicine, Korea University Medical Center, Seoul, Korea
| | - Dong Il Kim
- Department of Internal Medicine, Korea University Medical Center, Seoul, Korea
| | - Shin Gon Kim
- Department of Internal Medicine, Korea University Medical Center, Seoul, Korea
| | - Dong Seop Choi
- Department of Internal Medicine, Korea University Medical Center, Seoul, Korea
| | - Yun Jeong Jo
- Department of Laboratory Medicine, Korea University Medical Center, Seoul, Korea
| | - Byung Soo Kim
- Department of Internal Medicine, Korea University Medical Center, Seoul, Korea
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Fridlender ZG, Simon HU, Shalit M. Metastatic carcinoma presenting with concomitant eosinophilia and thromboembolism. Am J Med Sci 2003; 326:98-101. [PMID: 12920442 DOI: 10.1097/00000441-200308000-00008] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A case of a 58-year-old female patient who presented with significant blood eosinophilia and thromboembolic events is described. The patient was eventually diagnosed as suffering from a disseminated malignancy of gastrointestinal origin. Immunohistochemical studies of the tumor are presented. These studies show that tumor cells produce interleukin-3 and -5 and granulocyte macrophage-colony stimulating factor. These cytokines are known to support differentiation, proliferation, and survival of eosinophils. Their secretion is the probable explanation for the appearance of high blood eosinophilia in this patient. To the best of our knowledge, combined blood eosinophilia and thromboembolism as presenting manifestations of a solid tumor have never been reported.
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Affiliation(s)
- Zvi G Fridlender
- Department of Medicine, Hadassah University Hospital, POB 12000, Jerusalem, Israel.
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15
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Walter R, Joller-Jemelka HI, Salomon F. Metastatic squamous cell carcinoma with marked blood eosinophilia and elevated serum interleukin-5 levels. Exp Hematol 2002; 30:1-2. [PMID: 11823029 DOI: 10.1016/s0301-472x(01)00764-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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16
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Yuen BH, Reyes CV, Rawal PA, Sosman J, Jensen J. Severe eosinophilia and hepatocellular carcinoma: an unusual association. Diagn Cytopathol 1995; 13:151-4. [PMID: 8542796 DOI: 10.1002/dc.2840130215] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Peripheral eosinophilia is an unusual but recognized paraneoplastic manifestation of malignant diseases. We report a case of eosinophilia associated with hepatocellular carcinoma which is the second case described in English literature.
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Affiliation(s)
- B H Yuen
- Department of Medicine, Loyola University Medical Center, Maywood, IL 60153, USA
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17
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Richardson P, Dickinson G, Nash S, Hoffman L, Steingart R, Germain M. Crescentic glomerulonephritis and eosinophilic interstitial infiltrates in a patient with hypereosinophilic syndrome. Postgrad Med J 1995; 71:175-8. [PMID: 7746781 PMCID: PMC2398187 DOI: 10.1136/pgmj.71.833.175] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Crescentic glomerulonephritis with immune complex deposition and acute eosinophilic interstitial nephritis developed in a patient with the hypereosinophilic syndrome. Acute renal failure ensued but was rapidly reversed by high-dose oral prednisone. Confounding factors and unusual findings are described with a review of recent literature. This mode of presentation has not previously been reported.
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Affiliation(s)
- P Richardson
- Divisions of Hematology/Oncology, Pulmonology, Tufts University School of Medicine, Baystate Medical Center, Springfield, Massachusetts, USA
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18
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Grathwohl K, LeBrun C, Tenglin R. Eosinophilia of the blood. Postgrad Med 1995; 97:169-172. [DOI: 10.1080/00325481.1995.11945976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Affiliation(s)
- A J Wardlaw
- Department of Allergy and Clinical Immunology, National Heart & Lung Institute, London, England, United Kingdom
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20
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Fermand JP, Mitjavila MT, Le Couedic JP, Tsapis A, Berger R, Modigliani R, Seligmann M, Brouet JC, Vainchenker W. Role of granulocyte-macrophage colony-stimulating factor, interleukin-3 and interleukin-5 in the eosinophilia associated with T cell lymphoma. Br J Haematol 1993; 83:359-64. [PMID: 8485042 DOI: 10.1111/j.1365-2141.1993.tb04657.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
We studied two patients with a leukaemic T cell lymphoma who presented with a marked increase in blood eosinophilia. To investigate the mechanism of the eosinophilia, supernatants of peripheral blood cells containing more than 80% lymphoma cells were tested by biological assays for the presence of colony stimulating factors (CSF). In one case supernatants stimulated the growth of granulocyte-macrophage (GM), erythroid and eosinophil colonies. These effects were neutralized by anti-GM-CSF antibodies; anti-IL5 antibodies slightly decreased eosinophil colony formation. Supernatants derived from the second patient cells stimulated the same lineages. Neutralizing experiments demonstrated that in addition to GM-CSF it contained interleukin 3 (IL-3) and interleukin 5 (IL-5). In agreement with the biological data, RNA studies using the polymerase chain reaction showed that cells from the first patient expressed GM-CSF transcripts; IL-5 transcripts were also detected in very low amounts. GM-CSF, IL-3 and IL-5 transcripts were detected in cells from the second patient. Thus eosinophilia associated with some T cell lymphoma is likely due to secretion of different combinations of cytokines by malignant cells.
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Affiliation(s)
- J P Fermand
- Service d'Immuno-Hématologie, Hôpital Saint Louis, Paris, France
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Dalal BI, Das KC, Dutta TK, Malakar K. Local and systemic eosinophilia in patients with carcinoma of the uterine cervix undergoing radiation therapy: correlation with radiation response. Clin Oncol (R Coll Radiol) 1992; 4:18-21. [PMID: 1736974 DOI: 10.1016/s0936-6555(05)80766-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Forty-nine patients with squamous carcinoma of the uterine cervix undergoing supervoltage 60Co radiotherapy were investigated to determine the significance of quantitation of eosinophils in the tumour tissue as well as in blood. The blood absolute eosinophil count (AEC) at presentation was higher in patients with Stages III and IV disease (0.52 +/- 0.09 x 10(9)/l, mean +/- SEM) when compared with early stages (Stages I and II, 0.35 +/- 0.07 x 10(9)/l). Forty-four patients (90%) showed a steady rise in AEC during the course of therapy. The patients showing good radiation response (n = 13, greater than or equal to 50% regression), displayed a more pronounced rise in AEC during the course of radiotherapy (0.66 +/- 0.24 x 10(9)/l) and had more eosinophils in the tumour tissue (7.4 +/- 0.66/oil immersion field) than the poor responders (n = 36, less than 50% regression, rise in eosinophil count 0.22 +/- 0.04 x 10(9)/l, eosinophils in tumour tissue 2.9 +/- 0.55/oil emersion field, P less than 0.0001 for both parameters). We conclude that quantitation of eosinophils in blood and tumour tissue before and during radiotherapy in patients with squamous carcinoma of the uterine cervix is useful in predicting radiation response.
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Affiliation(s)
- B I Dalal
- Department of Haematology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 50-1991. A 71-year-old woman with a sensorimotor neuropathy and radiographically demonstrable abnormalities. N Engl J Med 1991; 325:1723-35. [PMID: 1658653 DOI: 10.1056/nejm199112123252408] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Abstract
Many disease states such as parasitic infestations, malignancies, collagen vascular diseases, and allergies are associated with eosinophilia. The diagnosis of idiopathic hypereosinophilic syndrome (HES) requires a persistent elevation in the total eosinophil count (greater than 1500/mm3) for over 6 months, associated organ damage and no detectable underlying cause. This review provides an updated summary of the cytokine cascade that controls eosinophil production and delineates our current understanding of the clinical features of hypereosinophilic states. We also examine the central role of T-lymphocyte activation in eosinophilia, and have attempted to integrate current treatment strategies for HES with the physiology of eosinophilopoiesis.
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Affiliation(s)
- J L Liesveld
- Hematology Unit, University of Rochester Medical Center, NY 14642
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