Resumen
La gastroenteritis eosinofílica es una enfermedad de etiopatogenia no aclarada y manifestación poco frecuente, con síntomas clínicos diversos, abarca desde cuadros leves abdominales inespecíficos hasta episodios agudos de obstrucción intestinal que en ocasiones hacen preciso el tratamiento quirúrgico urgente. Este amplio abanico sintomático parece estar condicionado por el grado de infiltración eosinofílica de la pared intestinal y el número de capas afectadas. Comunicamos un caso que por la dificultad diagnóstica ilustra, en un solo paciente, la diversidad anatomo-clínica del cuadro intestinal y respiratorio y la evolución de la eosinofilia intestinal y periférica. La paciente fue enviada a nuestro servicio con los diagnósticos de asma bronquial, rinitis crónica alérgica y anemia crónica persistente.
Referencias
Higgins GA, Lamm ER, Yutzy CV. Eosinophilic gastroenteritis. Arch Surg 1996:92:476.
Caldwell JH, Mekchjian, HS, Hurtubise PE, Beman FM. Eosinophilic gastroenteritis with obstruction; immunologic al studies of seven patients. Gastroenterology 1978;74:825-828.
Itellas KM, Bennet WF, Bova JG, Johnson JC, et al. Radiographic manifestation of eosinophilic gastroenteritis. Abdem Imaging 1995;20:406-413.
Goldblatt D, Thrasher AJ. Chronic granulomatous disease. Clin Exp Immunol 2000;122:1-9.
Khalilzadeh S, Boloursaz MR, Mansoury D, Baghaie N, et al. Clinical and radiological aspects of chronic granulomatous disease in children: a case series from Iran. Turkish Resp J 2006;7:78-81.
Cale CM, Jones AM, Goldblatt D. Follow up of patients with chronic granulomatous disease diagnosed since 1990. Clin Exp Immunol 2000;120:351-355.
Lakshman R, Finn A. Neutrophil disorders and their management. J Clin Pathol 2001;54:7-19.
Grumach AS, Bellinai-Pires R, Araujo IS, Gonzalez CH, Carneiro-Sampaio MM. Chronic granulomatous disease of childhood: differential diagnosis and prognosis. Rev Paul Med 1993;111:472-476.
Kamani N, Douglas SD. Natural history of chronic granulomatous disease. Diagn Clin Immunol 1988;5:314-317.
Liese JG, Jendrossek V, Jansson A, et al. Chronic granulomatous disease. Pediatr Clin North Am 1977;24:365-376.
Heltzer M, Jawad AF, Rae J, Curnutte JT, Sullivan KE. Diminished T cell numbers in patients with chronic granulomatous disease. Clin Immunol 2002;105:273-278.
Winkelstein JA, Marino K, Johnston RB, et al. Chronic granulomatous disease: report on a registry of 368 patients. Mol Immunol 1998;35:10.
Hasui M. Chronic granulomatous disease in Japan: incidence and natural history. The Study Group of Phagocyte Disorders of Japan. Pediatr Int 1999;41:589-593.
Ahlin A, De Boer M, Roos D, et al. Prevalence, genetics and clinical presentation of chronic granulomatous disease in Sweden. Acta Pediatrics 1995;84:1386-1394.
Kainulainen L, Nikoskelainen J, Ruuskanen O. Diagnostic findings in 95 Finnish patients with common variable immunodeficiency. J Clin Immunol 2001;21:145-149.
Marciano BE, Rosenzweig SD, Kleiner DE, Anderson VL, et al. Gastrointestinal involvement in chronic granulomatous disease. Pediatrics 2004;114:462-468.
Liese J, Kloos S, Jendrossek V, Petropoulou T, et al. Chronic granulomatous disease (CGD): incidence of infections and complications in 39 patients. Mol Med 1998;35:65.
Oleastro M, Galicchio, Roy A, et al. Enfermedad granulomatosa crónica: ¿cómo reconocerla? Arch Argent Pediatr 2001;99:498-502.
19. Heyworth P, Cross A, Curnutte J. Chronic granulomatous disease. Current Opinion Immunol 2003;15:578-584.
Lekstrom JA, Gallin JI. Immunodeficiency diseases caused by defects in phagocytes. N Engl J Med 2000;343:1703-1714.
Rosenzweig SD. Inflammatory manifestations in chronic granulomatous disease (CGD). J Clin Immunol 2008;28:67- 72.
Babior BM. NADPH oxidasa. Current Opinion Immunol 2004;16:42-47.
Assari T. Chronic granulomatous disease; fundamental stages in our understanding of CGD. Med Immunol 2006;5:4.
Wolach B, et al. Chronic granulomatous disease in Israel: Clinical, functional and molecular studies of 38 patients. Clin Immunol 2008;129:103-114.
Cos-Padrón Y, Marsán-Suárez V, Sánchez-Segura M, Macías AC. Enfermedad granulomatosa crónica. Aspectos actuales. Rev Cubana Hematol Inmunol Hemoter 2004;20:1-10.
Gamboa-Salcedo T, Cardoso-Hernández G, Saucedo-Ramírez OJ, Peña-Alonso YR. Burkholderia cepacia y enfermedad granulomatosa crónica. Informe de un caso. Bol Med Hosp Infant Mex 2009;66:68-75.
Segal B, Leto T, Gallin J, Malech H, Holland S. Genetic, biochemical, and clinical features of chronic granulomatous disease. Medicine 2000;79:170-200.
Johansson B, Wymann MP, Holmgren-Peterson K, Magnusson KE. N-formyl peptide receptors in human neutrophils display distinct membrane distribution and lateral mobility when labeled with agonist and antagonist. J Cell Biol 1993;121:1281-1289.
Ruíz Montes F, René Espinet J, Rubio Caballero M. Gastroenteritis eosinofílica: Revisión de los casos publicados en España y comparación con la literatura extranjera. Rev Esp Enferm Dig 1992;81:270-279.
Rodriguez Leal C, Tinoco Racero I, Téllez Pérez F, Girón González JA. Gastroenteritis eosinofílica. Medicine 2000;8:238-241.
Valley NJ, Shorter RG, Philips SF, Zinsmeister AR. Eosinophilic gastritis: clinicopathological study of patients with disease of the mucosa, muscle layer and subserosal tisues. Gut 1990;31:54-58.
Caldwell JH, Mekchjian, HS, Hurtubise PE, Beman FM. Eosinophilic gastroenteritis with obstruction; immunologic al studies of seven patients. Gastroenterology 1978;74:825-828.
Itellas KM, Bennet WF, Bova JG, Johnson JC, et al. Radiographic manifestation of eosinophilic gastroenteritis. Abdem Imaging 1995;20:406-413.
Goldblatt D, Thrasher AJ. Chronic granulomatous disease. Clin Exp Immunol 2000;122:1-9.
Khalilzadeh S, Boloursaz MR, Mansoury D, Baghaie N, et al. Clinical and radiological aspects of chronic granulomatous disease in children: a case series from Iran. Turkish Resp J 2006;7:78-81.
Cale CM, Jones AM, Goldblatt D. Follow up of patients with chronic granulomatous disease diagnosed since 1990. Clin Exp Immunol 2000;120:351-355.
Lakshman R, Finn A. Neutrophil disorders and their management. J Clin Pathol 2001;54:7-19.
Grumach AS, Bellinai-Pires R, Araujo IS, Gonzalez CH, Carneiro-Sampaio MM. Chronic granulomatous disease of childhood: differential diagnosis and prognosis. Rev Paul Med 1993;111:472-476.
Kamani N, Douglas SD. Natural history of chronic granulomatous disease. Diagn Clin Immunol 1988;5:314-317.
Liese JG, Jendrossek V, Jansson A, et al. Chronic granulomatous disease. Pediatr Clin North Am 1977;24:365-376.
Heltzer M, Jawad AF, Rae J, Curnutte JT, Sullivan KE. Diminished T cell numbers in patients with chronic granulomatous disease. Clin Immunol 2002;105:273-278.
Winkelstein JA, Marino K, Johnston RB, et al. Chronic granulomatous disease: report on a registry of 368 patients. Mol Immunol 1998;35:10.
Hasui M. Chronic granulomatous disease in Japan: incidence and natural history. The Study Group of Phagocyte Disorders of Japan. Pediatr Int 1999;41:589-593.
Ahlin A, De Boer M, Roos D, et al. Prevalence, genetics and clinical presentation of chronic granulomatous disease in Sweden. Acta Pediatrics 1995;84:1386-1394.
Kainulainen L, Nikoskelainen J, Ruuskanen O. Diagnostic findings in 95 Finnish patients with common variable immunodeficiency. J Clin Immunol 2001;21:145-149.
Marciano BE, Rosenzweig SD, Kleiner DE, Anderson VL, et al. Gastrointestinal involvement in chronic granulomatous disease. Pediatrics 2004;114:462-468.
Liese J, Kloos S, Jendrossek V, Petropoulou T, et al. Chronic granulomatous disease (CGD): incidence of infections and complications in 39 patients. Mol Med 1998;35:65.
Oleastro M, Galicchio, Roy A, et al. Enfermedad granulomatosa crónica: ¿cómo reconocerla? Arch Argent Pediatr 2001;99:498-502.
19. Heyworth P, Cross A, Curnutte J. Chronic granulomatous disease. Current Opinion Immunol 2003;15:578-584.
Lekstrom JA, Gallin JI. Immunodeficiency diseases caused by defects in phagocytes. N Engl J Med 2000;343:1703-1714.
Rosenzweig SD. Inflammatory manifestations in chronic granulomatous disease (CGD). J Clin Immunol 2008;28:67- 72.
Babior BM. NADPH oxidasa. Current Opinion Immunol 2004;16:42-47.
Assari T. Chronic granulomatous disease; fundamental stages in our understanding of CGD. Med Immunol 2006;5:4.
Wolach B, et al. Chronic granulomatous disease in Israel: Clinical, functional and molecular studies of 38 patients. Clin Immunol 2008;129:103-114.
Cos-Padrón Y, Marsán-Suárez V, Sánchez-Segura M, Macías AC. Enfermedad granulomatosa crónica. Aspectos actuales. Rev Cubana Hematol Inmunol Hemoter 2004;20:1-10.
Gamboa-Salcedo T, Cardoso-Hernández G, Saucedo-Ramírez OJ, Peña-Alonso YR. Burkholderia cepacia y enfermedad granulomatosa crónica. Informe de un caso. Bol Med Hosp Infant Mex 2009;66:68-75.
Segal B, Leto T, Gallin J, Malech H, Holland S. Genetic, biochemical, and clinical features of chronic granulomatous disease. Medicine 2000;79:170-200.
Johansson B, Wymann MP, Holmgren-Peterson K, Magnusson KE. N-formyl peptide receptors in human neutrophils display distinct membrane distribution and lateral mobility when labeled with agonist and antagonist. J Cell Biol 1993;121:1281-1289.
Ruíz Montes F, René Espinet J, Rubio Caballero M. Gastroenteritis eosinofílica: Revisión de los casos publicados en España y comparación con la literatura extranjera. Rev Esp Enferm Dig 1992;81:270-279.
Rodriguez Leal C, Tinoco Racero I, Téllez Pérez F, Girón González JA. Gastroenteritis eosinofílica. Medicine 2000;8:238-241.
Valley NJ, Shorter RG, Philips SF, Zinsmeister AR. Eosinophilic gastritis: clinicopathological study of patients with disease of the mucosa, muscle layer and subserosal tisues. Gut 1990;31:54-58.
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