Eosinophilic Cholecystitis Associated with Eosinophilic Granulomatosis with Polyangiitis.
Acute cholecystitis
Cerebral hemorrhage
Churg-Strauss syndrome
Eosinophilic cholecystitis
Eosinophilic granulomatosis with polyangiitis
Journal
Case reports in gastroenterology
ISSN: 1662-0631
Titre abrégé: Case Rep Gastroenterol
Pays: Switzerland
ID NLM: 101474819
Informations de publication
Date de publication:
Historique:
received:
20
08
2020
accepted:
18
09
2020
entrez:
14
1
2021
pubmed:
15
1
2021
medline:
15
1
2021
Statut:
epublish
Résumé
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.
Identifiants
pubmed: 33442347
doi: 10.1159/000511863
pii: crg-0014-0668
pmc: PMC7772830
doi:
Types de publication
Case Reports
Langues
eng
Pagination
668-674Informations de copyright
Copyright © 2020 by S. Karger AG, Basel.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to declare.
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