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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Immunologic evaluation of a patient with pancreatitis, subcutaneous fat necrosis, pleuritis, pericarditis and synovitis is presented. The previously recognized syndrome of pancreatic disease, subcutaneous fat necrosis and arthritis is reviewed. Based on analysis of all the cases described in the English language literature it is suggested that this syndrome be expanded to include polyserositis rather than arthritis alone. Although experimental and clinical evidence tends to implicate physiocochemical tissue injury by pancreatic lipase as the primary pathogenic mechanism in this syndrome, studies in our patient suggest the possible contribution of immune-mediated injury. Supporting data include eosinophilia, biopsy demonstration of vasculitis antedating the subcutaneous fat necrosis, immunofluorescent identification of immunoglobulin G (IgG) and C3 in the pleura, and reduced levels of total hemolytic complement in the serum, and pleural and pericardial effusions.
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PMID:Syndrome and pancreatic disease, subcutaneous fat necrosis and polyserositis. Case report and review of literature. 109 Jan 61

The marked diminution in the number of circulating eosinophils, which has been shown to occur during acute bacterial infections, is a distinctive aspect of eosinophil physiology and of the host response to acute infection. The mouse rendered eosinophilic by infection with trichinosis provides a suitable model for study of the eosinopenic response induced by acute inflammation. The alterations in eosinophil dynamics associated with acute inflammatory reactions in trichinous mice were studied with pneumococcal abscesses, with Escherichia coli pyelonephritis, with Coxsackie viral pancreatitis, and with acute subcutaneous inflammation due to turpentine. Each of these stimuli of acute inflammation markedly suppressed the eosinophilia of trichinosis. This suggests that the eosinopenia is a response to the acute inflammatory process rather than the response to a specific type of pathogen. These studies apply quantitative techniques to ascertain the effects of acute inflammation on eosinophil production in bone marrow and on distribution of eosinophils in the peripheral tissues. From these observations, it is apparent that the initial response to acute inflammation includes a rapid drop in numbers of circulating eosinophils, a rapid accumulation of eosinophils at the periphery of the inflammatory site, and an inhibition of egress of eosinophils from the bone marrow. With prolongation of the inflammatory process, inhibition of eosinopoiesis occurs.
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PMID:Behavior of eosinophil leukocytes in acute inflammation. II. Eosinophil dynamics during acute inflammation. 109 20

Two patients suffering from partial lipodystrophy, pancreatitis, and recurrent eosinophilia are described. In one patient the duodenum and the terminal ileum were narrowed, the appearances suggesting eosinophilic gastroenteritis: bilateral hydronephrosis was also present without ureteric obstruction. An association between lipodystrophy and renal disease is recognized; it is possible that there is also an association between lipodystrophy and pancreatitis, and eosinophilia with or without an intestinal lesion may be a further association.
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PMID:Lipodystrophy, pancreatitis, and eosinophilia. 112 78

Among 122 patients with chronic pancreatitis, marked eosinophilia (greater than 500 eosinophils/mm3 in the peripheral blood) was observed in 21 cases (17.2%). All of the affected patients were males, and there was no significant difference in the incidence of eosinophilia between patients with alcoholic and nonalcoholic pancreatitis. In the patients with eosinophilia, endocrine pancreatic function was maintained comparatively well, despite marked exocrine pancreatic dysfunction. The eosinophilia of chronic pancreatitis frequently developed in association with severe damage to neighboring organs (pleural effusion, pericarditis, and ascites), as well as in association with pancreatic pseudocyst. Our findings suggest that there is a close correlation between marked eosinophilia and severe tissue injury during acute exacerbations of chronic pancreatitis.
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PMID:Eosinophilia associated with chronic pancreatitis: an analysis of 122 patients with definite chronic pancreatitis. 137 90

Interleukin-2 (IL-2) is increasingly used to treat patients with cancers refractory to conventional treatment. Flu-like syndromes are extremely frequent but usually mild. A variety of skin complications (mostly erythema and mucositis) have been reported. Life-threatening skin reactions have also been described. Acute reactivation of psoriasis can also occur. Immediate hypersensitivity reactions have so far not been described, but IL-2 treatment has been shown to predispose to acute hypersensitivity reactions to iodine-containing contrast media. Hypothyroidism is the major endocrine complication and antithyroid antibodies have been detected in approximately 50% of patients. Neurological and psychiatric disturbances with moderate or severe mental status changes are common and sometimes treatment-limiting. The occurrence of peritumoural oedema in patients with brain metastases can also be a major practical problem. Musculoskeletal disorders are transient and resolve spontaneously. The vascular leak syndrome is the most frequent and severe complication of IL-2 of which weight gain, generalised oedema, hypotension and impaired renal function are the main features. Even though a damaging effect on vascular endothelium cells by various cytokines released by activated lymphoid cells or mediated by non-lymphocyte-dependent factors has been proposed to be involved, the mechanism remains unclear. Other cardiovascular injuries, possibly life-threatening, including myocarditis, angina pectoris and myocardial infarction, can occur during the first days of treatment. Supraventricular arrhythmias are the most common rhythmic disorder. Decreases in myocardial contractility and haemodynamic pattern similar to those of septic shock have been encountered in most cases. Acute renal dysfunction is common but resolves with symptomatic management. Intrahepatic cholestasis with hyperbilirubinaemia is observed in most patients but permanent liver damage has not been described. Several cases of pancreatitis have been reported. Anaemia, thrombocytopenia, lymphocytopenia and eosinophilia are frequent and occur in most if not all patients. Some data suggest a high incidence of infectious complications, particularly in patients with surgically tunnelled catheters, but marked flu-like syndromes may be confounding. Finally, death directly related to IL-2 treatment has been noted in less than 1% of all patients. Investigations are under way to minimise IL-2 toxicity with varying dose regimens and combined treatments.
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PMID:Clinical toxicity of interleukin-2. 141 98

Skin rash, fever, and eosinophilia developed in a previously healthy 35-year-old woman three weeks after starting carbamazepine. Fulminant respiratory and renal failure ensued. Autopsy showed pneumonitis, nephritis, serositis, pancreatitis, hepatitis, and carditis, characterized by an infiltrate of eosinophils and lymphocytes. The severity, duration, and extensive organ involvement of the reaction make this case unique.
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PMID:Carbamazepine-induced severe systemic hypersensitivity reaction with eosinophilia. 322 45

A total of 145 BB Wistar diabetic rats, 46 of their nondiabetic siblings, and 43 outbred Wistar rats were autopsied and the frequency of lesions in all organ systems were determined. Common strain-related lesions included pulmonary infections, granulomas, lymphoid hyperplasia, lymphomas, lymphocytopenia, eosinophilia, supradiaphragmatic accessory lobes of the liver, and prostatic atrophy. These suggest some basic strain-related abnormalities of the immune system that were selected by the process of inbreeding. Diabetes-related lesions were insulitis, testicular atrophy, cataracts, hepatic fatty change, pancreatitis, lymphocytic thyroiditis, hypoglycemic brain damage, central pontine myelinolysis, stomach erosions, and idiopathic megacolon. Many of these are sequelae of human juvenile-onset diabetes and support the validity of the BB Wistar rat as an animal model for human diabetes mellitus. The absence of several important sequelae of the human disease (i.e., diabetic nephropathy, atherosclerosis, and severe microangiopathy) suggests a degree of infidelity as a model for human diabetes mellitus. Nonspecific lesions occurring in all three groups of rats included myocardial degeneration and fibrosis, splenic extramedullary hematopoiesis, and chronic progressive glomerulonephropathy.
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PMID:Pathological lesions in the spontaneously diabetic BB Wistar rat: a comprehensive autopsy study. 634 94

We report herein what we think is the first case of an idiopathic hypereosinophilic syndrome in which jaundice (caused by eosinophilic pancreatitis) was the first major symptom. The duodenum and an antral polyp were also infiltrated by eosinophils. In our case, diagnosis was based upon the classic three fold criteria: a) persistent eosinophilia (greater than or equal to 1,500/mm3, b) lack of evidence for any other recognized cause of eosinophilia, c) multiple organ systemic involvement: skin, lymph nodes, heart (detected by routine echocardiography), nerves (discovered on electromyography), and later, arthritis and pleural effusion. Biological signs included increased plasmatic IgE levels (3,500 UI/ml), circulating immune complexes and absence of leukemic markers. This case emphasizes the difficulty in classifying eosinophilic infiltrations of the gut and the possibility of transitional forms between eosinophilic granuloma, eosinophilic gastroenteritis and the hypereosinophilic syndrome.
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PMID:[Icterus disclosing pancreatic involvement in idiopathic hypereosinophilic syndrome]. 651 6

Eosinophilia is frequently associated with allergic rhinitis, asthma, drug reactions, parasitic infections, malignant neoplasms, collagen vascular diseases, skin diseases, and pulmonary infiltrates. It has been infrequently described in conjunction with pancreatic diseases and not before, to my knowledge, with pseudocyst formation. A patient with alcohol-related pancreatitis manifested a transient eosinophilia during development of a massive pancreatic pseudocyst. Although he was atopic, with a greatly elevated serum IgE level, there was no recent contact with the specific allergen to which he was sensitized. This constellation of alcohol-related pancreatitis with pseudocyst formation, atopy with elevated serum IgE level, and transient eosinophilia is an interesting coincidence.
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PMID:Transient eosinophilia associated with pancreatitis and pseudocyst formation. 739 17

A 48-year-old man was admitted for the evaluation of a massive left pleural effusion. Thoracenthesis yielded a bloody excudate with a high percentage of eosinophils (27%) and high values of pancreatic enzymes (amylase 16,000 Somogyi, Elastase 35,000 ng/dl, Lipase 12,800 U/l, Trypsin 77,000 ng/ml). The amylase isozyme of the exudate was 100% pancreatic-type fraction. The blood showed no eosinophilia (4%). A computed tomographic scan and magnetic resonance image of the abdomen revealed a pancreatic pseudocyst in contact with the diaphragm, and thrombi in the inferior vena cava and the splenic vein. After pancreatic cystectomy and splenectomy, the pleural effusion resolved rapidly. Eosinophilic pleural effusion has been reported as a complication of several disorders: pneumonia, lung carcinoma, pulmonary tuberculosis, and pulmonary infarction. However, we know of no previous report of eosinophilic pleural effusion with pancreatitis. In this case, it is interesting that the massive eosinophilic pleural effusion associated with chronic pancreatitis resolved immediately after the operation, and the patient was discharged.
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PMID:[A case of chronic pancreatitis with eosinophilic pleural effusion]. 766 23


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