WordNet

of or relating to the tropics, or either tropic; "tropical year"
of weather or climate; hot and humid as in the tropics; "tropical weather" (同)tropic
relating to or situated in or characteristic of the tropics (the region on either side of the equator); "tropical islands"; "tropical fruit" (同)tropic
characterized by or of the nature of a trope or tropes; changed from its literal sense
either of two parallels of latitude about 23.5 degrees to the north and south of the equator representing the points farthest north and south at which the sun can shine directly overhead and constituting the boundaries of the Torrid Zone or tropics
a symptom of allergic states; increased eosinophils in the blood
a leukocyte readily stained with eosin (同)eosinophile

PrepTutorEJDIC

『熱帯の』,熱帯性の,熱帯産の / 酷暑の
〈C〉回帰線 / 《the tropics》熱帯地方 / 熱帯[地方]の(tropical)

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/12/07 18:05:54」(JST)

wiki en

Tropical (pulmonary) eosinophilia, or TPE, is characterized by coughing, asthmatic attacks, and an enlarged spleen, and is caused by Wuchereria bancrofti, a filarial infection. It occurs most frequently in India and Southeast Asia. Tropical eosinophilia is considered a manifestation of a species of microfilaria. This disease can be confused with tuberculosis,^[1] asthma, or coughs related to roundworms.^[2]

Tropical pulmonary eosinophilia is a rare, but well recognised, syndrome characterised by pulmonary interstitial infiltrates and marked peripheral eosinophilia.^[3] This condition is more widely recognised and promptly diagnosed in filariasis-endemic regions, such as the Indian subcontinent, Africa, Asia and South America. In nonendemic countries, patients are commonly thought to have bronchial asthma.^[4]^[5] Chronic symptoms may delay the diagnosis by up to five years.^[4] Early recognition and treatment with the antifilarial drug, diethylcarbamazine, is important, as delay before treatment may lead to progressive interstitial fibrosis and irreversible impairment.^[6]

The condition of marked eosinophilia with pulmonary involvement was first termed tropical pulmonary eosinophilia in 1950.^[7] The syndrome is caused by a distinct hypersensitive immunological reaction to microfilariae of W. bancrofti and Brugia malayi.^[6]^[8] However, only a small percentage (< 0.5%)^[9] of the 130 million people globally who are infected with filariasis apparently develop this reaction. The clearance of rapidly opsonised microfilariae from the bloodstream results in a hypersensitive immunological process and abnormal recruitment of eosinophils, as reflected by extremely high IgE levels of over 1000 kU/L.^[6]^[10] The typical patient is a young adult man from the Indian subcontinent.^[8]

Symptoms

A persistent or recurrent cough that gets aggravated at night, weakness, weight loss and a low fever raises the possible diagnosis of this disease. Some children with this disease may also have enlarged lymph nodes in the neck and elsewhere. Others may cough up a little blood and may also have a wheeze.^[1]

Diagnosis

The diagnostic criteria for tropical pulmonary eosinophilia ^[10] include:

a history supportive of exposure to lymphatic filariasis;
a peripheral eosinophilia count greater than 3 × 10⁹/L);
an elevated serum IgE levels (> 1000 kU/L);
increased titers of antifilarial antibodies;
peripheral blood negative for microfilariae; and
a clinical response to diethylcarbamazine.

High antifilarial IgG titers to microfilariae often result in cross reactivity with other nonfilarial helminth antigens,^[11] ^[12] such as strongyloides and schistosoma antigens, as demonstrated in reported cases. It is important to exclude other parasitic infections before tropical pulmonary eosinophilia is diagnosed, by serological tests, examination of stool specimens in a laboratory experienced in parasitic infections, or a trial of anthelminthic medication. Other parasitic infections, such as the zoonotic filariae, dirofilariasis, ascariasis, strongyloides, visceral larva migrans and hookworm disease, may also be confused with tropical pulmonary eosinophilia because of overlapping clinical features, serological profile and response to diethylcarbamazine.^[6]^[10]^[12]^[13] Radiological findings are nonspecific, with normal appearance on chest X-ray in up to 20% of patients.^[8] Lung biopsy is not part of the routine diagnostic workup of tropical pulmonary eosinophilia.^[3]

Treatment

The dramatic response to a commonly used drug for filaria (diethylcarbamazine) almost confirms the diagnosis. No universal treatment guidelines have been established for tropical pulmonary eosinophilia. ^[4] The antifilarial diethylcarbamazine (6 mg/kg/day in three divided doses^[3] for 21 days^[9] remains the main therapeutic agent, and is generally well tolerated. Reported side effects include headache, fever, pruritus and gastrointestinal upset.^[14] The eosinophil count often falls dramatically within 7–10 days of starting treatment.^[3]^[6]

References

^ ^a ^b "Pulmonary Eosinophilia". Retrieved 2011-04-16.
^ "ICD-10 Classification". Retrieved 2011-04-16.
^ ^a ^b ^c ^d Yong, M.; Marshall, C.; Eisen, D. (2007). "Tropical pulmonary eosinophilia: A rare cause of cough in immigrants to Australia". The Medical journal of Australia 187 (7): 416–418. PMID 17908009. edit
^ ^a ^b ^c Boggild, A. K.; Keystone, J. S.; Kain, K. C. (2004). "Tropical Pulmonary Eosinophilia: A Case Series in a Setting of Nonendemicity". Clinical Infectious Diseases 39 (8): 1123–1128. doi:10.1086/423964. PMID 15486834. edit
^ Jiva, T.; Israel, R.; Poe, R. (1996). "Tropical pulmonary eosinophilia masquerading as acute bronchial asthma". Respiration; international review of thoracic diseases 63 (1): 55–58. doi:10.1159/000196517. PMID 8833995. edit
^ ^a ^b ^c ^d ^e Ong, R.; Doyle, R. (1998). "Tropical pulmonary eosinophilia". Chest 113 (6): 1673–1679. doi:10.1378/chest.113.6.1673. PMID 9631810. edit
^ Ball, J. (1950). "Tropical pulmonary eosinophilia". Transactions of the Royal Society of Tropical Medicine and Hygiene 44 (3): 237–258. doi:10.1016/0035-9203(50)90053-8. PMID 14809749. edit
^ ^a ^b ^c Udwaida F. (1975). "Tropical eosinophilia". In Herzog H. Pulmonary eosinophilia: progress in respiration research. Basel, Switzerland: Karger. pp. 35–155.
^ ^a ^b "Lymphatic filariasis: The disease and its control. Fifth report of the WHO Expert Committee on Filariasis". World Health Organization technical report series 821: 1–71. 1992. PMID 1441569. edit
^ ^a ^b ^c Ottesen, E. A.; Nutman, T. B. (1992). "Tropical Pulmonary Eosinophilia". Annual Review of Medicine 43: 417–424. doi:10.1146/annurev.me.43.020192.002221. PMID 1580599. edit
^ Muck, A.; Pires, M.; Lammie, P. (2003). "Influence of infection with non-filarial helminths on the specificity of serological assays for antifilarial immunoglobulin G4". Transactions of the Royal Society of Tropical Medicine and Hygiene 97 (1): 88–90. doi:10.1016/s0035-9203(03)90033-2. PMID 12886811. edit
^ ^a ^b Magnaval, J. -F.; Berry, A. (2005). "Tropical Pulmonary Eosinophilia". Clinical Infectious Diseases 40 (4): 635–636. doi:10.1086/427755. PMID 15712096. edit
^ Kuzucu, A. (2006). "Parasitic diseases of the respiratory tract". Current Opinion in Pulmonary Medicine 12 (3): 212–221. doi:10.1097/01.mcp.0000219271.80804.9e. PMID 16582677. edit
^ McLaughlin, S.; Radday, J.; Michel, M.; Addiss, D.; Beach, M.; Lammie, P.; Lammie, J.; Rheingans, R.; Lafontant, J. (2003). "Frequency, severity, and costs of adverse reactions following mass treatment for lymphatic filariasis using diethylcarbamazine and albendazole in Leogane, Haiti, 2000". The American journal of tropical medicine and hygiene 68 (5): 568–573. PMID 12812348. edit

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 熱帯性肺好酸球増多症 tropical pulmonary eosinophilia
2. 肺好酸球増多症の原因 causes of pulmonary eosinophilia
3. リンパ管フィラリア症の疫学、病因、および臨床症状 epidemiology pathogenesis and clinical manifestations of lymphatic filariasis
4. 好酸球の生物学および好酸球増多症の原因 eosinophil biology and causes of eosinophilia
5. 原因不明の好酸球増加症患者に対するアプローチ approach to the patient with unexplained eosinophilia

English Journal

[Combined immunodeficiency with cutaneous manifestations associated with DOCK8 mutation].

Cantisano C1, Díaz H1, Balbaryski J1, Oleastro M2, Quiroz H1, Gaddi E1.
Archivos argentinos de pediatría.Arch Argent Pediatr.2014 Aug;112(4):e147-51. doi: 10.1590/S0325-00752014000400014.
Different primary immunodeficiencies present increased levels of IgE and cutaneous infections of viral etiology. We report a case of a 2 y, 8 m old boy with combined immunodeficiency, dermatitis and disseminated molluscum contagiosum. The patient presented high titers of IgE, eosinophilia and pronou
PMID 24955914

Endothelial and leukocyte heparan sulfates regulate the development of allergen-induced airway remodeling in a mouse model.

Ge XN1, Ha SG1, Rao A1, Greenberg YG1, Rushdi MN1, Esko JD2, Rao SP1, Sriramarao P3.
Glycobiology.Glycobiology.2014 Aug;24(8):715-27. doi: 10.1093/glycob/cwu035. Epub 2014 May 2.
Heparan sulfate (HS) proteoglycans (HSPGs) participate in several aspects of inflammation because of their ability to bind to growth factors, chemokines, interleukins and extracellular matrix proteins as well as promote inflammatory cell trafficking and migration. We investigated whether HSPGs play
PMID 24794009

Japanese Journal

The Helminthic Eosinophilic Meningitides : Emerging Zoonotic Parasitic Diseases Worldwide

DIAZ James H.
Tropical
The helminthic infections that can cause eosinophilic meningitis (EM) share many of the characteristics of emerging infectious diseases, such as the influences of international trade and travel on pat …
NAID 10027895382

Amyloidosis kidney with filariasis presenting as nephrotic syndrome : Incidental finding or unusual association?

TEWARSON Sneh Lata,MANNAN Rahul,MISRA Vatsala,SINGH Pramela Antony,SINGH Mamta,AGGARWAL Vandana,MEHROTRA Ravi,TEWARSON Naresh Chandra
Tropical
… <B>Background</B>: It is estimated that around 120 million people in tropical and subtropical areas of the world are infected by filariasis. … The provisional diagnosis of amyloidosis kidney was confirmed by positivity on methyl violet staining.<B>Conclusion</B>: In the present case, the clinical picture did not provide any clue regarding the association of amyloidosis kidney with filariasis except for mild peripheral eosinophilia. …
NAID 10025714972

Deep vein thrombosis and pulmonary thromboembolism in a patient with eosinophilia and obesity

Nakamura Hideki,Aramaki Toshiyuki,Arima Kazuhiko,Iwamoto Naoki,Nakajima Hideki,iwanaga Nozomi,Kawakami Atsushi,Ida Hiroaki,Origuchi Tomoki,Yamachika Shiro,Tsuchihashi Yoshiko,Kamihira Shimeru,Eguchi Katsumi
Acta medica Nagasakiensia 52(3), 87-91, 2007-10-00
… Eosinophilia coupled with remarkable obesity was considered to be the trigger of DVT in this patient. …
NAID 110006433208

Related Pictures

Tropical Pulmonary Eosinophilia: An Epidemiological and Clinical Review 20 pulmonary disease with eosinophilia Hypersensitivity pneumonitis and pulmonary eosinophilia syndromes Pulmonary eosinophilia; Eosinophilia, Pulmonary; Eosinophilic Pneumonia; Loeffler A Case of Tropical Eosinophilia in a Foreign Worker in Singapore | Meyyur Aravamudan PPT - Lymphatic Filariasis PowerPoint Presentation - ID:1273185