Eosinophilic Cholecystitis Associated with Eosinophilic Granulomatosis with Polyangiitis
We report a case of eosinophilic cholecystitis associated with eosinophilic granulomatosis with polyangiitis (EGPA) complicated by cerebral hemorrhage. A 60-year-old man presented to a local hospital with a diagnosis of acute cholecystitis, with persistent fever and epigastric pain for 2 weeks. His...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Karger Publishers
2020-12-01
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| Series: | Case Reports in Gastroenterology |
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| Online Access: | https://www.karger.com/Article/FullText/511863 |
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| author | Hiroyuki Ito Yusuke Mishima Tsubomi Cho Naoki Ogiwara Yoshimasa Shinma Masashi Yokota Kazuya Anzai Shingo Tsuda Junko Nagata Seiichiro Kojima Noriko Sasaki Takayuki Wakabayashi Norihito Watanabe Takayoshi Suzuki |
| author_facet | Hiroyuki Ito Yusuke Mishima Tsubomi Cho Naoki Ogiwara Yoshimasa Shinma Masashi Yokota Kazuya Anzai Shingo Tsuda Junko Nagata Seiichiro Kojima Noriko Sasaki Takayuki Wakabayashi Norihito Watanabe Takayoshi Suzuki |
| author_sort | Hiroyuki Ito |
| collection | DOAJ |
| description | We report a case of eosinophilic cholecystitis associated with eosinophilic granulomatosis with polyangiitis (EGPA) complicated by cerebral hemorrhage. A 60-year-old man presented to a local hospital with a diagnosis of acute cholecystitis, with persistent fever and epigastric pain for 2 weeks. His symptoms persisted despite 3-week hospitalization; therefore, he was transferred to our hospital for further evaluation. Laboratory investigations upon admission showed white blood cells 26,300/µL and significant eosinophilia (eosinophils 61%). Abdominal computed tomography revealed no gallbladder enlargement but a circumferentially edematous gallbladder wall. Additional blood test results were negative for antineutrophil cytoplasmic and perinuclear antineutrophil cytoplasmic antibodies; however, immunoglobulin (Ig)G and IgE levels were high at 1,953 mg/dL and 3,040/IU/mL, respectively. He improved following endoscopic transnasal gallbladder drainage for cholecystitis and was diagnosed with EGPA and received corticosteroid and immunosuppressant combination therapy. The eosinophil count decreased immediately after treatment, and abdominal pain and numbness resolved. He returned with left-sided suboccipital hemorrhage likely attributed to EGPA 6 months after discharge. EGPA is characterized by inflammation of small blood vessels and clinically manifests with an allergic presentation of bronchial asthma, as well as renal dysfunction, interstitial pneumonia, enteritis, and cerebral hemorrhage. Few reports have described cholecystitis as a presenting symptom of EGPA. We report a rare case of such a presentation with added considerations. |
| first_indexed | 2024-12-14T10:27:37Z |
| format | Article |
| id | doaj.art-070b1ca4baae4bb9839b5efd0bfa6f10 |
| institution | Directory Open Access Journal |
| issn | 1662-0631 |
| language | English |
| last_indexed | 2024-12-14T10:27:37Z |
| publishDate | 2020-12-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Gastroenterology |
| spelling | doaj.art-070b1ca4baae4bb9839b5efd0bfa6f102022-12-21T23:06:16ZengKarger PublishersCase Reports in Gastroenterology1662-06312020-12-0114366867410.1159/000511863511863Eosinophilic Cholecystitis Associated with Eosinophilic Granulomatosis with PolyangiitisHiroyuki ItoYusuke MishimaTsubomi ChoNaoki OgiwaraYoshimasa ShinmaMasashi YokotaKazuya AnzaiShingo TsudaJunko NagataSeiichiro KojimaNoriko SasakiTakayuki WakabayashiNorihito WatanabeTakayoshi SuzukiWe report a case of eosinophilic cholecystitis associated with eosinophilic granulomatosis with polyangiitis (EGPA) complicated by cerebral hemorrhage. A 60-year-old man presented to a local hospital with a diagnosis of acute cholecystitis, with persistent fever and epigastric pain for 2 weeks. His symptoms persisted despite 3-week hospitalization; therefore, he was transferred to our hospital for further evaluation. Laboratory investigations upon admission showed white blood cells 26,300/µL and significant eosinophilia (eosinophils 61%). Abdominal computed tomography revealed no gallbladder enlargement but a circumferentially edematous gallbladder wall. Additional blood test results were negative for antineutrophil cytoplasmic and perinuclear antineutrophil cytoplasmic antibodies; however, immunoglobulin (Ig)G and IgE levels were high at 1,953 mg/dL and 3,040/IU/mL, respectively. He improved following endoscopic transnasal gallbladder drainage for cholecystitis and was diagnosed with EGPA and received corticosteroid and immunosuppressant combination therapy. The eosinophil count decreased immediately after treatment, and abdominal pain and numbness resolved. He returned with left-sided suboccipital hemorrhage likely attributed to EGPA 6 months after discharge. EGPA is characterized by inflammation of small blood vessels and clinically manifests with an allergic presentation of bronchial asthma, as well as renal dysfunction, interstitial pneumonia, enteritis, and cerebral hemorrhage. Few reports have described cholecystitis as a presenting symptom of EGPA. We report a rare case of such a presentation with added considerations.https://www.karger.com/Article/FullText/511863acute cholecystitiscerebral hemorrhagechurg-strauss syndromeeosinophilic cholecystitiseosinophilic granulomatosis with polyangiitis |
| spellingShingle | Hiroyuki Ito Yusuke Mishima Tsubomi Cho Naoki Ogiwara Yoshimasa Shinma Masashi Yokota Kazuya Anzai Shingo Tsuda Junko Nagata Seiichiro Kojima Noriko Sasaki Takayuki Wakabayashi Norihito Watanabe Takayoshi Suzuki Eosinophilic Cholecystitis Associated with Eosinophilic Granulomatosis with Polyangiitis Case Reports in Gastroenterology acute cholecystitis cerebral hemorrhage churg-strauss syndrome eosinophilic cholecystitis eosinophilic granulomatosis with polyangiitis |
| title | Eosinophilic Cholecystitis Associated with Eosinophilic Granulomatosis with Polyangiitis |
| title_full | Eosinophilic Cholecystitis Associated with Eosinophilic Granulomatosis with Polyangiitis |
| title_fullStr | Eosinophilic Cholecystitis Associated with Eosinophilic Granulomatosis with Polyangiitis |
| title_full_unstemmed | Eosinophilic Cholecystitis Associated with Eosinophilic Granulomatosis with Polyangiitis |
| title_short | Eosinophilic Cholecystitis Associated with Eosinophilic Granulomatosis with Polyangiitis |
| title_sort | eosinophilic cholecystitis associated with eosinophilic granulomatosis with polyangiitis |
| topic | acute cholecystitis cerebral hemorrhage churg-strauss syndrome eosinophilic cholecystitis eosinophilic granulomatosis with polyangiitis |
| url | https://www.karger.com/Article/FullText/511863 |
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