Dense eosinophilic infiltration of the mucosa preceding ulcerative colitis and mimicking eosinophilic colitis: Report of two cases

UZUNİSMAİL, Hülya; DOĞUSOY, Gülen; HATEMI, ALI IBRAHIM; ONAT, Akın

Dense eosinophilic infiltration of the mucosa preceding ulcerative colitis and mimicking eosinophilic colitis: Report of two cases

Hülya UZUNİSMAİL, (İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, Gastroenteroloji Anabilim Dalı, İstanbul, Türkiye)

İbrahim HATEMİ, (İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, Gastroenteroloji Anabilim Dalı, İstanbul, Türkiye)

Gülen DOĞUSOY, (İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, Patoloji Anabilim Dalı, İstanbul, Türkiye)

Akın ONAT (Patomed, İstanbul, Türkiye)

Turkish Journal of Gastroenterology

7 1

Yıl: 2006 Cilt: 17 Sayı: 1 Sayfa Aralığı: 53 - 57 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Dense eosinophilic infiltration of the mucosa preceding ulcerative colitis and mimicking eosinophilic colitis: Report of two cases

Öz:

Eozinofillerin inflamatuar barsak hastalığı patogenezinde yer aldıklarına dair kanıtlar artmaktadır. Bu yazıda ilk atakları sırasında histopatolojik olarak eozinofilik kolit tanısı alan iki ülseratif kolit vakası sunulmaktadır. Hastalar ilk atakları sırasında ketotifen ve metronidazol ile semptomatik düzelme göstermişlerdir. Bununla beraber sonraki ataklarda histopatolojik olarak ülseratif kolit tanısı konmuş ve yukarıda belirtilen tedaviden yarar görmemişlerdir. Sağaltımlarında 5-ASA ve kortikosteroid kullanımı gerekli olmuştur, ikinci vakada tedaviye azathioprin de eklenmesi zorunlu olmuştur. Bu vakalardaki yoğun eozinofil infiltrasyonu ülseratif kolit vakalarının bir kısmında atakların ortaya çıkmasında eozinofillerin rolü olabileceğini düşündürmektedir.

Anahtar Kelime: İshal Eozinofiller Kolit, ülseratif

Konular: Cerrahi

Ülseratif kolit öncesi eozinofilik koliti taklit eden yoğun mukozal eozinofil infiltrasyonu: İki olgu sunumu

Öz:

There is increasing evidence about the involvement of eosinophils in the pathogenesis of inflammatory bowel disease. We report here two patients with ulcerative colitis who were initially diagnosed as eosinophilic colitis based on histopathological examination during their first attacks. They had symptomatic improvement with ketotifen and metronidazole during their first attacks. However, subsequent attacks which were histopathologically diagnosed as ulcerative colitis did not resolve with the above-mentioned treatment and necessitated a treatment with 5-ASA agents plus corticosteroids. Azathioprine also had to be added in the treatment of the second patient. Dense eosinophilic infiltration in these cases may suggest a role of eosinophils in the initiation of attacks in some ulcerative colitis patients.

Anahtar Kelime: Eosinophils Colitis, Ulcerative Diarrhea

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Olgu Sunumu Erişim Türü: Erişime Açık

1. Wardlaw AJ, Barry Kay A. Eosinophils and their disorders. In: Beutler E, Lichtman MA, Coller BS, Kipps TJ, Seligshon U, eds. William’s Haematology. Sixth ed. New York: McGraw Hill, 2001; 785-99. 2. Keshavarzian A, Saverymuttu SH, Tai PC, et al. Activated eosinophils in familial eosinophilic gastroenteritis. Gastroenterology 1985; 88: 1041-9. 3. Talley NJ, Kephart GM, McGovern TW, et al. Deposition of eosinophil granule major basic protein in eosinophilic gastroenteritis and celiac disease. Gastroenterology 1992; 103: 137-45. 4. Colombel JF, Torpier G, Janin A, et al. Activated eosinophils in adult coeliac disease: evidence for a local release of major basic protein. Gut 1992; 33: 1190-4. 5. Levy AM, Yamazaki K, Van Keulen VP, et al. Increased eosinophil infiltration and degranulation in colonic tissue from patients with collagenous colitis. Am J Gastroenterol 2001; 96: 1522-8. 6. Bischoff SC, Wedemeyer J, Herrmann A, et al. Quantitative assessment of intestinal eosinophils and mast cells in inflammatory bowel disease. Histopathology 1996; 28: 1- 13. 7. Dvorak AM. Ultrastructural evidence for release of major basic protein -containing crystalline cores of eosinophil granules in vivo: Cytotoxic potential in Crohn’s disease. J Immunol 1980; 125: 460-2. 8. Raab Y, Fredens K, Gerdin B, Hallgren R. Eosinophil activation in ulcerative colitis: studies on mucosal release and localization of eosinophil granule constituents. Dig Dis Sci 1998; 43: 1061-70. 9. Bischoff SC, Mayer J, Nguyen QT, Stolte M. Immunohistological assessment of intestinal eosinophil activation in patients with eosinophilic gastroenteritis and inflammatory bowel disease. Am J Gastroenterol 1999; 94: 3521-9. 10. Carlson M, Raab Y, Peterson C, et al. Increased intraluminal release of eosinophil granule proteins EPO, ECP, EPX, and cytokines in ulcerative colitis and proctitis in segmental perfusion. Am J Gastroneterol 1999; 94: 1876-83. 11. Berstad A, Borkje B, Riedel B, et al. Increased fecal eosinophil cationic protein in inflammatory bowel disease. Hepatogastroenterology 1993; 40: 276-8. 12. Bischoff SC, Grabowsky J, Manns MP. Quantification of inflammatory mediators in stool samples of patients with inflammatory bowel disorders and controls. Dig Dis Sci 1997; 42: 394-403. 13. Saitoh O, Kojima K, Sugi K, et al. Fecal eosinophil granule derived proteins reflect disease activity in inflammatory bowel disease. Am J Gastroenterol 1999; 94: 3513-20. 14. Levy AM, Gleich GJ, Sandborn WJ, et al. Increased eosinophil granule proteins in gut lavage fluid from patients with inflammatory bowel disease. Mayo Clin Proc 1997; 72: 117-23. 15. Troncone R, Caputo N, Esposito V, et al. Increased concentrations of eosinophilic cationic protein in whole gut lavage fluid from children with inflammatory bowel disease. J Pediatr Gastroenterol Nutr 1999; 28: 164-8. 16. Seo M, Okada M, Tsuneyashi Y, et al. An index of disease activity in patients with ulcerative colitis. Am J Gastroenterol 1992; 87: 971-6. 17. Fuss IJ, Neurath M, Boirivant M, et al. Disparate CD4+ lamina propria (LP) lymphokine secretion profiles in inflammatory bowel disease. Crohn's disease LP cells manifest increased secretion of IFN-gamma, whereas ulcerative colitis LP cells manifest increased secretion of IL-5. J Immunol 1996; 157(3): 1261-70. 18. Matsuzaki K, Hokari R, Kato S, et al. Differential expression of CCR5 and CRTH2 on infiltrated cells in colonic mucosa of patients with ulcerative colitis. J Gastroenterol Hepatol 2003; 18: 1081-8. 19. Rankin SM, Conroy DM, Williams TJ. Eotaxin and eosinophil recruitment: Implications for human disease. Mol Med Today 2000; 6: 20-7. 20. Chen W, Paulus B, Shu D, et al. Increased serum levels of eotaxin in patients with inflammatory bowel disease. Scand J Gastroenterol 2001; 36: 515-20. 21. Mir A, Minguez M, Tatay J, et al. Elevated serum eotaxin levels in patients with inflammatory bowel disease. Am J Gastroenterol 2002; 97: 1452-7. 22. Seegert D, Rosentiel P, Pfahler H, et al. Increased expression of IL-16 in inflammatory bowel disease. Gut 2001; 48: 326-32. 23. Mathy NL, Scheuer W, Lanzendorfer M, et al. Interleukin –16 stimulates the expression and production of proinflammatory cytokines by human monocytes. Immunology 2000; 100: 63-9. 24. Dubucquoi S, Janin A, Klein O, et al. Activated eosinophils and interleukin 5 expression in early recurrence of Crohn’s disease. Gut 1995; 37: 242-6. 25. Desreumaux P, Brandt E, Gambiez L, et al. Distinct cytokine patterns in early and chronic ileal lesions of Crohn’s disease. Gastroenterology 1997; 113: 118-26. 26. Niessner M, Volk BA. Altered Th1/Th2 cytokine profiles in the intestinal mucosa of patients with inflammatory bowel disease as assessed by quantitative reversed transcribed polymerase chain reaction (RT-PCR). Clin Exp Immunol 1995; 1001: 428-35. 27. Thepen T, Langeveld-Wildschut EG, Bihari IC, et al. Biphasic response against aeroallergen in atopic dermatitis showing a switch from an initial Th2 response to a Th1 response. J Allergy Clin Immunol 1996; 97: 828-37. 28. Iijima H, Takahashi I, Kishi D, et al. Alteration of interleukin 4 production results in the inhibition of Thelper type 2 cell-dominated inflammatory bowel disease in T cell receptor alpha chain-deficient mice. J Exp Med 1999; 190: 607-15. 29. Boirivant M, Fuss I, Chu A, Strober W. Oxazolone colitis: a murine model of T helper type 2 colitis treatable with antibodies to interleukin-4. J Exp Med 1998; 16: 1929-39. 30. Bischoff SC, Mayer JH, Manns M. Allergy and the gut. Int Arch Allergy Immunol 2000; 121: 270-83. 31. Heatley RV, James PD. Eosinophils in the rectal mucosa. A simple method of predicting the outcome of ulcerative proctocolitis. Gut 1978; 20: 787-91. 32. Jones NL, Roifman CM, Griffiths AM, Sherman P. Ketotifen therapy for acute ulcerative colitis in children: A pilot study. Dig Dis Sci 1998; 43: 609-15.

APA	UZUNİSMAİL H, HATEMI A, DOĞUSOY G, ONAT A (2006). Dense eosinophilic infiltration of the mucosa preceding ulcerative colitis and mimicking eosinophilic colitis: Report of two cases. , 53 - 57.
Chicago	UZUNİSMAİL Hülya,HATEMI ALI IBRAHIM,DOĞUSOY Gülen,ONAT Akın Dense eosinophilic infiltration of the mucosa preceding ulcerative colitis and mimicking eosinophilic colitis: Report of two cases. (2006): 53 - 57.
MLA	UZUNİSMAİL Hülya,HATEMI ALI IBRAHIM,DOĞUSOY Gülen,ONAT Akın Dense eosinophilic infiltration of the mucosa preceding ulcerative colitis and mimicking eosinophilic colitis: Report of two cases. , 2006, ss.53 - 57.
AMA	UZUNİSMAİL H,HATEMI A,DOĞUSOY G,ONAT A Dense eosinophilic infiltration of the mucosa preceding ulcerative colitis and mimicking eosinophilic colitis: Report of two cases. . 2006; 53 - 57.
Vancouver	UZUNİSMAİL H,HATEMI A,DOĞUSOY G,ONAT A Dense eosinophilic infiltration of the mucosa preceding ulcerative colitis and mimicking eosinophilic colitis: Report of two cases. . 2006; 53 - 57.
IEEE	UZUNİSMAİL H,HATEMI A,DOĞUSOY G,ONAT A "Dense eosinophilic infiltration of the mucosa preceding ulcerative colitis and mimicking eosinophilic colitis: Report of two cases." , ss.53 - 57, 2006.
ISNAD	UZUNİSMAİL, Hülya vd. "Dense eosinophilic infiltration of the mucosa preceding ulcerative colitis and mimicking eosinophilic colitis: Report of two cases". (2006), 53-57.

APA	UZUNİSMAİL H, HATEMI A, DOĞUSOY G, ONAT A (2006). Dense eosinophilic infiltration of the mucosa preceding ulcerative colitis and mimicking eosinophilic colitis: Report of two cases. Turkish Journal of Gastroenterology, 17(1), 53 - 57.
Chicago	UZUNİSMAİL Hülya,HATEMI ALI IBRAHIM,DOĞUSOY Gülen,ONAT Akın Dense eosinophilic infiltration of the mucosa preceding ulcerative colitis and mimicking eosinophilic colitis: Report of two cases. Turkish Journal of Gastroenterology 17, no.1 (2006): 53 - 57.
MLA	UZUNİSMAİL Hülya,HATEMI ALI IBRAHIM,DOĞUSOY Gülen,ONAT Akın Dense eosinophilic infiltration of the mucosa preceding ulcerative colitis and mimicking eosinophilic colitis: Report of two cases. Turkish Journal of Gastroenterology, vol.17, no.1, 2006, ss.53 - 57.
AMA	UZUNİSMAİL H,HATEMI A,DOĞUSOY G,ONAT A Dense eosinophilic infiltration of the mucosa preceding ulcerative colitis and mimicking eosinophilic colitis: Report of two cases. Turkish Journal of Gastroenterology. 2006; 17(1): 53 - 57.
Vancouver	UZUNİSMAİL H,HATEMI A,DOĞUSOY G,ONAT A Dense eosinophilic infiltration of the mucosa preceding ulcerative colitis and mimicking eosinophilic colitis: Report of two cases. Turkish Journal of Gastroenterology. 2006; 17(1): 53 - 57.
IEEE	UZUNİSMAİL H,HATEMI A,DOĞUSOY G,ONAT A "Dense eosinophilic infiltration of the mucosa preceding ulcerative colitis and mimicking eosinophilic colitis: Report of two cases." Turkish Journal of Gastroenterology, 17, ss.53 - 57, 2006.
ISNAD	UZUNİSMAİL, Hülya vd. "Dense eosinophilic infiltration of the mucosa preceding ulcerative colitis and mimicking eosinophilic colitis: Report of two cases". Turkish Journal of Gastroenterology 17/1 (2006), 53-57.