title: [Eosinophilic cholangitis from almost normal appearance to the bile duct sclerosis similar to primary sclerosing cholangitis].
abstract: A 48-year-old man was admitted to our hospital because of eosinophilia and liver dysfunction. Initial abdominal CT and MRI (MRCP) finding showed almost normal liver and bile duct. Liver biopsy demonstrated mild portal infiltration of lymphocytes and eosinophils. Definitive diagnosis was difficult, but we suspected autoimmune disease. Oral steroid administration was started, which led to a rapid improvement of eosinophilia and liver dysfunction. Dose reduction of steroid administration resulted in exacerbation of eosinophilia and liver dysfunction. Follow-up MRCP and ERCP study revealed biliary strictures similar to primary sclerosing cholangitis (PSC). A second liver biopsy revealed dense infiltration composed of lymphocytes and eosinophils in the portal area. Therefore we diagnosed eosinophilic cholangitis. This is the first case of eosinophilic cholangitis, observed after changes of the bile duct from an almost normal appearance to diffuse sclerosing and narrowing similar to PSC by imaging and pathological studies.
authors: Department of Gastroenterology and Hepatology, Kobe City Medical Center West Hospital, Japan. kimura19801118@hotmail.co.jp
authors: Yoshito
authors: Y
authors: Kimura
authors: Yukimasa
authors: Y
authors: Yamashita
authors: Sakae
authors: S
authors: Mikami
authors: Hiroshi
authors: H
authors: Ono
authors: Ryosuke
authors: R
authors: Itai
authors: Yoshihide
authors: Y
authors: Matsumoto
authors: Satoshi
authors: S
authors: Yamada
authors: Mariko
authors: M
authors: Takada
authors: Yasuhiko
authors: Y
authors: Sumitomo
mesh_terms: D001652:Bile Ducts / Q000473:pathology*; D002761:Cholangitis / Q000000981:diagnostic imaging / Q000473:pathology*; D015209:Cholangitis, Sclerosing / Q000000981:diagnostic imaging / Q000473:pathology*; D004802:Eosinophilia / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012598:Sclerosis / Q000473:pathology; D014057:Tomography, X-Ray Computed