Estudo sobre a ocorrência e as causas de lesões eosinofílicas teciduais e suas características clínicas, epidemiológicas e diagnósticas

Abstract

Eosinophilic tissue lesions can be present in various situations, whether as primary or secondary causes. When secondary, these lesions may be associated with tissue parasitoses that activate the immune system and induce excessive eosinophil production. The two forms of interest for this study are eosinophilic gastroenteritis and eosinophilic meningitis. Part of the study involved a retrospective analysis and review of reports and histopathological slides from the Pathology Laboratory of HUCAM to investigate the occurrence of eosinophilic tissue lesions in the state of Espírito Santo. Another part of the study was carried out prospectively, monitoring cases of eosinophilic meningitis (EM) occurring in Brazil, as well as monitoring blood eosinophilia in the municipalities of Ibatiba and Santa Maria de Jetibá, Espírito Santo, and serologically assessing serum samples for the presence of antibodies against A. costaricensis. A total of 12,284 histopathological reports of the gastrointestinal tract (GI) from the years 2008 to 2023 were reviewed. The percentage of cases with resection/biopsy of some portion of the GI that showed the presence of eosinophils was 8.2% in the small intestine, 2.8% in the large intestine, 1.9% in the liver, and 0.5% in the cecal appendix. Eight cases presented parasitic structures. The Eosinophilic Meningitis Monitoring Network currently includes the participation of the institutions Hospital Nossa Senhora da Conceição in Porto Alegre - RS and Hospital Infantil Dr. Jeser Amarante Faria in Joinville – SC. These institutions reported eight cases of meningitis with eosinophilia, with the quantity of eosinophils ranging from 2 to 68%. The monitoring of blood eosinophilia in the municipalities of Ibatiba and Santa Maria de Jetibá resulted in the collection and analysis of 24 samples, of which 9 tested positive for the Dot-ELISA. Based on the results found, it can be confirmed that there are cases with eosinophilic tissue lesions, as well as the presence of high levels of eosinophils in both blood and cerebrospinal fluid. Therefore, it is important for these lesions to be the focus of investigation, with the collaboration of all professionals involved in surveillance and epidemiological research.