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Id: biblio-1011115
Autor: Kieselova, Katarina; Santiago, Felicidade; Henrique, Martinha.
Título: Incapacitating solar urticaria: successful treatment with omalizumab
Fonte: An. bras. dermatol;94(3):331-333, May-June 2019. graf.
Idioma: en.
Resumo: Abstract: Solar urticaria is a rare form of physical urticaria mediated by immunoglobulin E. The lesions appear immediately after the sun exposure, interfering with the patient's normal daily life. Omalizumab, a monoclonal anti-IgE antibody, has been recently approved for the treatment of chronic spontaneous urticaria, and the latest reports support its role also in the treatment of solar urticaria. Hereby, we report a case of solar urticaria refractory to conventional treatment strategies, with an excellent response to treatment with omalizumab and phototesting normalization.
Descritores: Luz Solar/efeitos adversos
Urticária/tratamento farmacológico
Antialérgicos/uso terapêutico
Omalizumab/uso terapêutico
-Transtornos de Fotossensibilidade/diagnóstico
Transtornos de Fotossensibilidade/etiologia
Transtornos de Fotossensibilidade/tratamento farmacológico
Urticária/diagnóstico
Urticária/etiologia
Limites: Seres Humanos
Masculino
Meia-Idade
Tipo de Publ: Relatos de Casos
Responsável: BR1.1 - BIREME


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Alchorne, Alice de Oliveira de Avelar
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Id: biblio-1011090
Autor: Criado, Paulo Ricardo; Maruta, Celina Wakisaka; Alchorne, Alice de Oliveira de Avelar; Ramos, Andréa Machado Coelho; Gontijo, Bernardo; Santos, Josemir Belo dos; Martins, Luis Eduardo Agner Machado; Rivitti-Machado, Maria Cecília; Silvares, Maria Regina Cavariani; Pires, Mario Cezar; Souza, Patricia Karla de; Orfali, Raquel Leão; Bonamigo, Renan Rangel; Bedrikow, Roberta Buense; Criado, Roberta Fachini Jardim; Oliveira, Zilda Najjar Prado de.
Título: Consensus on the diagnostic and therapeutic management of chronic spontaneous urticaria in adults - Brazilian Society of Dermatology
Fonte: An. bras. dermatol;94(2,supl.1):56-66, Mar.-Apr. 2019. tab, graf.
Idioma: en.
Resumo: Abstract: Background: Urticarias are frequent diseases, with 15% to 20% of the population presenting at least one acute episode in their lifetime. Urticaria are classified in acute ( ≤ 6 weeks) or chronic (> 6 weeks). They may be induced or spontaneous. Objectives: To verify the diagnostic and therapeutic recommendations in chronic spontaneous urticaria (CSU), according to the experience of Brazilian experts, regarding the available guidelines (international and US). Methods: A questionnaire was sent to Brazilian experts, with questions concerning diagnostic and therapeutic recommendations for CSU in adults. Results: Sixteen Brazilian experts answered the questionnaire related to diagnosis and therapy of CSU in adults and data were analyzed. Final text was written, considering the available guidelines (International and US), adapted to the medical practices in Brazil. Diagnostic work up in CSU is rarely necessary. Biopsy of skin lesion and histopathology may be indicated to rule out other diseases, such as, urticarial vasculitis. Other laboratory tests, such as complete blood count, CRP, ESR and thyroid screening. Treatment of CSU includes second-generation anti-histamines (sgAH) at licensed doses, sgAH two, three to fourfold doses (non-licensed) and omalizumab. Other drugs, such as, cyclosporine, immunomodulatory drugs and immunosuppressants may be indicated (non-licensed and with limited scientific evidence). Conclusions: Most of the Brazilian experts in this study partially agreed with the diagnostic and therapeutic recommendations of the International and US guidelines. They agreed with the use of sgAH at licensed doses. Increase in the dose to fourfold of sgAH may be suggested with restrictions, due to its non-licensed dose. Sedating anti-histamines, as suggested by the US guideline, are indicated by some of the Brazilian experts, due to its availability. Adaptations are mandatory in the treatment of CSU, due to scarce or lack of other therapeutic resources in the public health system in Brazil, such as omalizumab or cyclosporine.
Descritores: Urticária/diagnóstico
Urticária/tratamento farmacológico
Consenso
-Sociedades Médicas
Urticária/prevenção & controle
Índice de Gravidade de Doença
Brasil
Doença Crônica
Antialérgicos/uso terapêutico
Ciclosporinas/uso terapêutico
Antagonistas dos Receptores Histamínicos H1 não Sedativos/uso terapêutico
Dermatologia
Omalizumab/uso terapêutico
Imunossupressores/uso terapêutico
Limites: Seres Humanos
Adulto
Responsável: BR1.1 - BIREME


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Id: biblio-951922
Autor: Lv, Cheng-zhe; Huang, Ming; Zhang, Quan-ying; Zong, Shun-lin; Wang, Meng.
Título: Pharmacokinetics and safety of repirinast tablets in healthy Chinese subjects
Fonte: Braz. J. Pharm. Sci. (Online);54(2):e00232, 2018. tab, graf.
Idioma: en.
Resumo: ABSTRACT Repirinast is a new, synthetic, disodium cromoglycate-like antiallergic agent for oral administration in humans. This study evaluated the safety, tolerability and pharmacokinetics of repirinast tablets in healthy Chinese volunteers. This was a phase I, open-label, randomized, single- and multiple-dose study. Subjects were assigned to receive a single dose of repirinast tablet at either 150, 300, or 450 mg, or multiple doses of 150 mg twice daily for 5 days. Plasma samples were analyzed with LC-MS/MS. Pharmacokinetic parameters of active metabolite MY-1250 (deesterified repirinast) were calculated using non-compartmental analysis with WinNonlin software. Statistical analysis was performed using SPSS software. All adverse events (AEs) were mild and of limited duration. No serious adverse event (SAE), death or withdrawal from the study was observed. In the single-dose study, Cmax was reached at about 0.75 hour, and the mean t1/2 was approximately 16.21 hours. Area under curve (AUC) and Cmax increased with dose escalation, but dose proportionality was not observed over the range of 150 to 450 mg. In the multiple-dose study, the steady-state was reached within 3 days with no accumulation. Repirinast tablet was well tolerated in healthy Chinese subjects.
Descritores: Comprimidos/classificação
China/etnologia
-Dose Repetida
Dose Única/métodos
Ensaio Clínico Controlado Aleatório
Antialérgicos/análise
Antialérgicos/farmacocinética
Limites: Seres Humanos
Masculino
Feminino
Adulto
Responsável: BR1.1 - BIREME


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Id: lil-775991
Autor: Felix, Mara Morelo R; Felix, Mara Morelo R; Malaman, Maria Fernanda; Ensina, Luis Felipe C; Felix, Mara Morelo R; Felix, Mara Morelo R; Grupo de Assessoria em Alergiaa Medicamentos da ASBAI; Reis, Gladys; Queiroz, Silva de; Nunes, Inês Cristina Camelo; Landgraf, Loraine Farias; Gonçalves, Tânia Maria Tavares; Menezes, Ullissis Pádua de.
Título: Parecer técnico da ASBAI sobre o uso da penicilina G em unidades básicas de saúde / The ASBAI technical report on the use of penicillin G at primary care health clinics
Fonte: Braz. j. allergy immunol;2(4):129-131, July-Aug.2014.
Idioma: pt.
Resumo: Este artigo é resultado de um Parecer Técnico solicitado pelo Ministério da Saúde (MS) sobre o posicionamento da ASBAI quanto à Portaria n° 3161, de 27/12/2011 que “Dispõe sobre a administração da Penicilina nas unidades de atenção básica à saúde (UBS), no âmbito do Sistema Único de Saúde (SUS)”. A Portaria anterior, n° 156 de 19/01/2006 do MS, enfatiza a importância da sífilis congênita, que ainda hoje constitui grave problema de saúde pública. Nesta Portaria, recomenda-se que toda UBS deve contar com os seguintes materiais para atendimento à anafilaxia: máscara e cilindro para administração de oxigênio; epinefrina; prometazina; fenoterol; cloreto de sódio 0,9%, entre outros. Em 2011, a Portaria n° 156/2006 foi revogada pelo MS, que publicou a Portaria n° 3161, de 27/12/2011. Nesta nova Portaria não são mencionados os materiais e medicamentos que constavam na Portaria n° 156/2006. De todo modo, determina que a penicilina seja administrada em todas as UBS do SUS, pela equipe de enfermagem, médicos e farmacêuticos e que em caso de reações anafiláticas, deve-se proceder de acordo com os protocolos que abordam a atenção às urgências no âmbito da Atenção Básica à Saúde. O Grupo de Assessoria da ASBAI em Alergia a Medicamentos sugere que todas as UBS do SUS disponham de pessoal capacitado para o diagnóstico e tratamento de reações alérgicas. No caso de uma reação grave, como uma anafilaxia, o diagnóstico deve ser feito na UBS e, após as medidas iniciais, o paciente deve ser encaminhado para um serviço de referência...

The present article is the result of a technical report requested by the Brazilian Ministry of Health regarding ASBAI's position regarding Ordinance no. 3161, issued December 27, 2011,which regulates the administration of penicillin at primary health care clinics of the Brazilian Unified Health System. Previous Ordinance no. 156, issued January 19, 2006, highlighted the importance of congenital syphilis, which continues to be a serious public health problem. That Ordinance recommended that all health centers should have the following materials available for the management of anaphylaxis: face mask and oxygen cylinder; epinephrine; promethazine; fenoterol; 0.9% sodium chloride; among other materials. In 2011, Ordinance no. 156/2006 was replaced with Ordinance no. 3161/2011. This new Ordinance does not mention the materials and drugs previously included in Ordinance no. 156/2006. Conversely, it determines that penicillin should be administered at all public health clinics by nurses, doctors, and pharmacists, and that anaphylactic reactions be dealt with according to emergency protocols applicable to the primary health care setting. The Advisory Group for Drug Allergies at ASBAI recommends that all primary care heath clinics have staff trained in the diagnosis and treatment of allergic reactions. In the case of a severe reaction, such as anaphylaxis, diagnosis should be made at the health clinic, and the patient should be referred to a tertiary care center once the initial measures have been carried out...
Descritores: Anafilaxia
Antialérgicos/efeitos adversos
Prova Pericial
Hipersensibilidade
Atenção Primária à Saúde
Penicilina G/efeitos adversos
-Técnicas e Procedimentos Diagnósticos
Métodos
Pacientes
Limites: Seres Humanos
Tipo de Publ: Relatório Técnico
Responsável: BR32.1 - Serviço de Biblioteca e Informação Biomédica


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Id: lil-735743
Autor: Criado, Paulo Ricardo; Criado, Roberta Facchini Jardim; Maruta, Celina Wakisaka; Reis, Vitor Manoel Silva dos.
Título: Chronic urticaria in adults: state-of-the-art in the new millennium
Fonte: An. bras. dermatol;90(1):74-89, Jan-Feb/2015. tab, graf.
Idioma: en.
Resumo: Chronic urticaria has been explored in several investigative aspects in the new millennium, either as to its pathogenesis, its stand as an autoimmune or auto-reactive disease, the correlation with HLA-linked genetic factors, especially with class II or its interrelation with the coagulation and fibrinolysis systems. New second-generation antihistamines, which act as good symptomatic drugs, emerged and were commercialized over the last decade. Old and new drugs that may interfere with the pathophysiology of the disease, such as cyclosporine and omalizumab have been developed and used as treatments. The purpose of this article is to describe the current state of knowledge on aspects of chronic urticaria such as, pathophysiology, diagnosis and the current therapeutic approach proposed in the literature.
Descritores: Urticária/tratamento farmacológico
Urticária/patologia
-Corticosteroides/uso terapêutico
Antialérgicos/uso terapêutico
Anti-Inflamatórios/uso terapêutico
Doença Crônica
Antagonistas dos Receptores Histamínicos/uso terapêutico
Testes Cutâneos
Urticária/classificação
Urticária/etiologia
Limites: Adulto
Feminino
Seres Humanos
Masculino
Tipo de Publ: Revisão
Responsável: BR1.1 - BIREME


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Id: lil-734416
Autor: Máspero, Jorge; Cabrera, Hugo; Ardusso, Ledit; De Gennaro, Mónica; Fernández Bussy, Ramón; Galimany, José; Galimberti, Daniel; Label, Marcelo; La Forgia, Marta; Medina, Iris; Neffen, Hugo; Troielli, Patricia.
Título: Guía Argentina de urticaria y angioedema
Fonte: Medicina (B.Aires);74(supl.1):1-53, ago. 2014. ilus, tab.
Idioma: es.
Resumo: Se actualiza el diagnóstico de la urticaria crónica (UC) y los conceptos, definiciones y sugerencias basados en la evidencia para su tratamiento. La urticaria ocurre en al menos 20% de la población en algún momento de la vida. Su etiología difiere en la forma aguda (menos de 6 semanas), y en la crónica. No es posible pronosticar si las formas agudas evolucionarán a UC, ya que todas son agudas al comienzo. La UC ocurre como espontánea (UCE) o inducible (UCI). El diagnóstico es sencillo, pero incluye un minucioso estudio para descartar diagnósticos diferenciales; para UCI son útiles las pruebas de provocación en la caracterización y manejo. Los estudios complementarios se deben limitar y orientar según sospecha clínica. El tratamiento se divide en tres enfoques: evitación, eliminación o tratamiento del estímulo desencadenante o de la causa, y tratamiento farmacológico. Recientemente éste se modificó, con empleo de antihistamínicos de segunda generación como primera línea y aumento de dosis de antihistamínicos H1 no sedantes, hasta 4 veces, como segunda línea. Los antihistamínicos son fundamentales para tratar la UC; sin embargo, un 40% de los pacientes no logra un buen control pese al aumento de dosis y requiere otro medicamento adicional. La evidencia más reciente considera que un grupo de fármacos puede utilizarse como tercera línea en estos casos, para mejorar la calidad de vida y limitar la toxicidad por el uso frecuente o crónico de esteroides sistémicos. Se recomiendan para esta tercera línea solo 3 fármacos: omalizumab, ciclosporina A o antileucotrienos.

This interdisciplinary paper summarizes the news in the diagnosis and treatment of chronic urticaria (CU), and provides concepts, definitions and evidence-based suggestions for its management. Urticaria occurs in at least 20% of the population at some point in their lives. Acute urticaria (less than 6 weeks' duration), differs from CU in its etiology, but the onset of this disease is always acute. CU may occur as spontaneous (SCU) or induced (ICU). The diagnosis is simple, although a careful evaluation is necessary for differential diagnosis. ICU´s diagnosis is mainly clinical, even if provocation tests can be useful. Supplementary studies should be limited and based on the clinical suspicion. Treatment may be divided into three approaches: avoidance, elimination or treatment of the cause, and pharmacological treatment. Recently treatment has been modified with the use of second-generation antihistamines as first-line and increased doses of nonsedating H1 antihistamines, up to 4 times, as second line. Antihistamines are essential to treat CU; however, 40% of patients do not achieve good control despite increased doses and require additional treatment. The most recent evidence indicates a group of drugs to be used as third line in these cases, to improve quality of life and to limit toxicity from frequent or chronic use of systemic steroids. Only 3 drugs are recommended as third line: omalizumab, cyclosporin A or anti-leukotrienes.
Descritores: Antialérgicos/uso terapêutico
Antagonistas dos Receptores Histamínicos/uso terapêutico
Urticária/diagnóstico
Urticária/tratamento farmacológico
Urticária/etiologia
-Algoritmos
Argentina
Angioedema/tratamento farmacológico
Angioedema/patologia
Anticorpos Anti-Idiotípicos/uso terapêutico
Anticorpos Monoclonais Humanizados/uso terapêutico
Doenças Autoimunes/complicações
Doença Crônica
Ensaios Clínicos como Assunto
Ciclosporina/uso terapêutico
Diagnóstico Diferencial
Medicina Baseada em Evidências/economia
Imunoglobulina E/metabolismo
Antagonistas de Leucotrienos/uso terapêutico
Omalizumab
Qualidade de Vida
Urticária/classificação
Urticária/complicações
Urticária/fisiopatologia
Limites: Seres Humanos
Tipo de Publ: Guia de Prática Clínica
Responsável: AR1.2 - Instituto de Investigaciónes Epidemiológicas


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Id: lil-700468
Autor: Díez, Libia Susana; Tamayo, Liliana María; Cardona, Ricardo.
Título: Omalizumab: opción terapéutica para la urticaria crónica espontánea de difícil control con vasculitis asociada, reporte de tres casos / Omalizumab: therapeutic option in chronic spontaneous urticaria difficult to control with associated vasculitis, report of three cases
Fonte: Biomédica (Bogotá);33(4):503-512, Dec. 2013. ilus, tab.
Idioma: es.
Resumo: Introducción. Aproximadamente el 50 % de los casos de urticaria crónica no mejoran adecuadamente con las dosis convencionales de antihistamínicos, por lo cual se han planteado múltiples opciones terapéuticas, entre las cuales el omalizumab es una herramienta novedosa que ahora cuenta con evidencia de alta calidad que soporta su uso en los casos difíciles, que mejora rápidamente el índice sintomático y el uso de medicamentos, y cuenta con un buen perfil de seguridad. Objetivo. Presentar tres casos de mujeres adultas con urticaria crónica espontánea de más de ocho años de evolución, que no mejoraron con el tratamiento con altas dosis de antihistamínicos, asociados a antileucotrienos e inmunomoduladores y en quienes se combinaban varios mecanismos fisiopatológicos: urticaria crónica espontánea con componente de autoinmunidad, componente de presión y urticaria vasculítica. Materiales y métodos. Se reportan los casos con sus respectivas evaluaciones clínicas y de laboratorio, los medicamentos usados y la respuesta después del inicio de omalizumab y se hace una revisión de la literatura científica sobre uso de este medicamento en la urticaria crónica. Resultados. En los tres casos presentados se obtuvo una mejoría completa de los síntomas tras el inicio del omalizumab. Conclusión. El omalizumab es una opción terapéutica exitosa en casos de urticaria crónica de difícil control con vasculitis asociada, cuando se han agotado las opciones propuestas por las guías internacionales.

Introduction: Approximately 50% of chronic urticaria cases do not respond adequately to conventional doses of antihistamines, so a number of other therapeutic options have been suggested. Among these, omalizumab is an innovative tool, which now has high-quality evidence that supports its use in difficult cases, rapidly improving the symptom index and the use of medications with a good safety profile. Objective: To report three cases of adult women with spontaneous chronic urticaria with an evolution of more than eight years, which did not improve with high doses of antihistamines and leukotriene receptor blockers, associated with immunomodulatory therapy in which several etiologic mechanisms were combined: chronic spontaneous urticaria with autoimmune and pressure components, and vasculitis. Materials and methods: We report the cases with their clinical and laboratory evaluations, used medication, the response after the start of omalizumab and we performed a review of the literature on the use of this drug in chronic urticaria. Results: In all the presented cases, we obtained complete improvement of symptoms after starting omalizumab. Conclusion: Omalizumab is a successful treatment option in cases of difficult to control chronic urticaria with associated vasculitis in which the options proposed by international guidelines have been exhausted.
Descritores: Antialérgicos/uso terapêutico
Anticorpos Anti-Idiotípicos/uso terapêutico
Anticorpos Monoclonais Humanizados/uso terapêutico
Urticária/complicações
Urticária/tratamento farmacológico
Vasculite/complicações
-Doença Crônica
Limites: Adulto
Feminino
Seres Humanos
Meia-Idade
Tipo de Publ: Relatos de Casos
Responsável: CO332 - Facultad de Medicina


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Id: lil-687011
Autor: Nirmal, Sunil; Barwal, Surekha; Dhasade, Vipul; Patil, Anuja.
Título: Effects of Punica granatum on milk-induced leucocytosis and eosinophilia in mice / Efecto de Punica granatum en ratas con leucocitosis y eosinofilia inducida por leche
Fonte: Bol. latinoam. Caribe plantas med. aromát;10(3):222-227, mayo 2011. ilus.
Idioma: en.
Resumo: Punica granatum Linn. (Punicaceae) commonly known as Pomegranate is a dark greenish large deciduous shrub or small tree, about 5-10 m height. Flower buds are traditionally used in the treatment of asthma and allergy. The aim of this study was to validate the traditional antiallergic property using milk-induced leucocytosis and milk-induced eosinophilia in rats. Flower buds of the plant were extracted successively using various solvents to obtain the respective extracts. These extracts were administered to mice at the dose of 50 and 100 mg/kg, orally. Only the ethanol extract showed significant reduction in leukocyte and eosinophil count, these results are a validation of the use of the extract of polar compounds of P. granatum flower buds as an antiallergic agent.

Punica granatum Linn. (Punicaceae) comúnmente conocida como granada es un pequeño árbol o arbusto grande de hoja caduca, de unos 50-10 m de altura y de color verde oscuro. Los botones florales se utilizan tradicionalmente en el tratamiento del asma y la alergia. El objetivo de este estudio fue validar la propiedad tradicional antialérgica utilizando ratas con leucocitosis y eosinofilia inducida por leche. Los botones florales de la planta se extrajeron sucesivamente con varios solventes para obtener los extractos respectivos. Estos extractos se administraron a los ratones a dosis de 50 y 100 mg / kg, por vía oral. Sólo el extracto obtenido con etanol mostró una reducción significativa en el recuento de leucocitos y eosinófilos, estos resultados son una validación del uso del extracto de compuestos polares de los botones florales de P. granatum como un agente antialérgico.
Descritores: Antialérgicos/uso terapêutico
Eosinofilia/tratamento farmacológico
Extratos Vegetais/uso terapêutico
Granatum/uso terapêutico
Leucocitose/tratamento farmacológico
Punicaceae
-Antialérgicos/farmacologia
Etanol
Eosinófilos
Extratos Vegetais/farmacologia
Leucócitos
Limites: Masculino
Animais
Camundongos
Responsável: CL1.1 - Biblioteca Central


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Id: lil-677218
Autor: Monsalve, Emilia; Pastén, Albert; Muñoz, Camila.
Título: Psicosis inducida por corticoides en un adolescente: reporte de un caso clínico / Corticosteroid – induced psychosis in an adolescent: a clinical case report
Fonte: Rev. Soc. Psiquiatr. Neurol. Infanc. Adolesc;22(3):208-212, dic. 2011.
Idioma: es.
Resumo: La psicosis inducida por corticoides es una entidad clínica muy poco frecuente dentro de la práctica psiquiátrica infanto-juvenil. Presentamos el caso de un adolescente de 14 años que recibió terapia corticoidal intramuscular, endovenosa y oral para tratar un cuadro alérgico, que debuta posteriormente con un episodio psicótico a los pocos días de haber finalizado dicho tratamiento. Se muestrla presentación clínica, el enfrentamiento diagnóstico-terapéutico inicial, el manejo de especialidad y el seguimiento posterior.

The Corticosteroid induced psychosis is a rare clinical entity within the child and adolescent psychiatric practice. We report a case of a 14 years adolescent that received intramuscular, intravenous and oral corticosteroid therapy to treat an allergy, who debuts later with a psychotic episode a few days after finishing such treatment. It is shown the clinical presentation, the initial diagnostic and therapeutic confrontation, the specialist management and the follow up.
Descritores: Corticosteroides/efeitos adversos
Psicoses Induzidas por Substâncias/diagnóstico
Psicoses Induzidas por Substâncias/tratamento farmacológico
-Antialérgicos/efeitos adversos
Antipsicóticos/uso terapêutico
Benzodiazepinas/uso terapêutico
Resultado do Tratamento
Limites: Seres Humanos
Masculino
Adolescente
Tipo de Publ: Relatos de Casos
Responsável: CL1.1 - Biblioteca Central


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Id: lil-648812
Autor: Amarillo, Hugo A; Avellaneda, Roberto; Manson, Roberto; Rodríguez, Carlos; Amarillo, Hugo R.
Título: Colitis eosinofílica: a propósito de 3 casos y revisión de la literatura / Eosinophilic colitis: report of three cases and literature review
Fonte: Rev. argent. coloproctología;19(4):254-257, dic. 2008. ilus.
Idioma: es.
Resumo: Introducción: Existen afecciones inflamatorias que afectan el colon en forma infrecuente, con amplia variedad en su presentación clínica. Entre ellas, las colitis colágena, indeterminadas, infecciosas, císticas y eosinofílicas, entre otras. La colitis eosinofílica es una enfermedad crónica inflamatoria de etiología desconocida caracterizada por la infiltración masiva de eosinófilos en un segmento del tubo digestivo. Objetivo: Analizar los hallazgos clínicos, histológicos y terapéuticos asociados a la colitis eosinofílica. Diseño: Presentación de casos. Revisión de la literatura. Métodos: Revisión de registros en bases MEDLINE, LILACS y registros de AMA. Pacientes: Se analizaron 3 casos de presentación en los últimos 12 meses. Resultados: Caso 1: femenino, 40 años, dolor abdominal cólico y diarrea. Tomografía Computada: engrosamiento de colon derecho. Colonoscopía: colitis localizada en colon derecho con enantema, congestión sin ulceras. Parasitológico negativo. Caso 2: femenino 26 años, diarrea severa con deshidratación. Parasitológico positivo. Tratamiento con metronidazol sin respuesta. Colonoscopía: pancolitis moderada. Inicia tratamiento con corticoides. Caso 3: femenino 33 años, diarrea, pujo y tenesmo. Perdida de peso. VEDA normal. Colon por enema: dolicocolon. Colonoscopía: tiflitis con ileon normal. Parasitológico negativo. Tratamiento con mesalazina con buena respuesta. Todos tuvieron eosinofilia mayor al 8%. Todas las biopsias fueron del colon derecho y revelaron colitis crónica eosinofílica. Conclusiones: El diagnóstico definitivo es de necesidad para diferenciarlas de enfermedades inflamatorias del colon mediante colonoscopía y biopsia (en especial Enfermedad de Crohn). El tratamiento es sintomático y comprende una variedad de drogas (ketotifeno, corticoides, antihistamínicos, metronidazol, etc.)... (TRUNCADO)

Introduction: There is uncommon colitis with unfrequented presentation. Eosinophilic colitis is an inflammatory chronic bowel disease with unknown etiology. Objective: To evaluate clinical, histological and therapeutic findings and differential diagnosis of chronic eosinophilic colitis. Design: Case report and literature review. Patients: To analyze 3 cases in last 12 months. Results: Case 1: female, 40y, abdominal pain and diarrhea. CT: right colon involvement. Endoscopy: unspecific colitis. Positive Biopsy and negative parasitologic exam. Case 2: female, 26y, severe diarrhea, dehidratation. Positive parasitologic exam. Treatment with metronidazole without reponse. Endoscopy: mild pancolitis with positive biopsy. Treatment with steroids is instaured. Case 3: female, 33y, diarrhea and tenesmus, lost of weight. Upper endoscopy normal, lower endoscopy: cecal inflamation with positive biopsy. Negative parasitologic exam. All patients presented elevated blood eosinophilia and the biopsy were taken from right colon. Conclusions: Symptomatic treatment should be instituted with several drugs according to literature, steroids seems to be the better choice, but with secondary effects. Differential diagnosis should be done always, principally with Crohn's disease. Current allergic exposition plus environment contamination could represent the physiopathology in some of these cases.
Descritores: Colite/diagnóstico
Colite/etiologia
Colite/terapia
Eosinofilia/diagnóstico
Eosinofilia/terapia
-Antialérgicos/uso terapêutico
Colonoscopia
Diagnóstico Diferencial
Esteroides/uso terapêutico
Doenças Inflamatórias Intestinais
Limites: Seres Humanos
Adulto
Feminino
Tipo de Publ: Relatos de Casos
Revisão
Responsável: AR1.1 - Biblioteca Rafael Herrera Vegas



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