Fukatsu Shusaku, Kitamura Katsuya, Asai Yasutsugu, Nagai Kazumasa, Kikuchi Miho, Asano Kyoko, Tadokoro Kenichi, Yamanishi Fumito, Tomita Yusuke, Abe Masakazu, Wada Takuya, Matsue Yubu, Nutahara Daisuke, Taira Junichi, Nakamura Hironori, Itoi Takao
Department of Gastroenterology and Hepatology Tokyo Medical University Hachioji Medical Center Tokyo Japan.
Department of Gastroenterology and Hepatology Tokyo Medical University Tokyo Japan.
JGH Open. 2020 Nov 10;5(2):314-316. doi: 10.1002/jgh3.12454. eCollection 2021 Feb.
A 15-year-old boy was referred to our hospital with elevated hepatobiliary enzyme levels and jaundice. Magnetic resonance cholangiopancreatography performed at the previous medical facility revealed a stricture of the intrahepatic and extrahepatic bile duct. Computed tomography showed dilatation and wall thickness of the intrahepatic bile ducts. Primary sclerosing cholangitis or cholangiocarcinoma was suspected. Endoscopic retrograde cholangiopancreatography (ERCP) showed stricture in the intrahepatic and extrahepatic bile duct. On admission, the eosinophil count in the peripheral blood was normal; however, rapid hypereosinophilia in the peripheral blood was observed after admission, leading us to suspect eosinophilic cholangitis (EC). A bile duct biopsy showed inflammatory cells and eosinophil infiltration during a second ERCP. The patient was diagnosed with EC based on histopathology.
一名15岁男孩因肝胆酶水平升高和黄疸被转诊至我院。先前医疗机构进行的磁共振胰胆管造影显示肝内和肝外胆管狭窄。计算机断层扫描显示肝内胆管扩张和壁增厚。怀疑为原发性硬化性胆管炎或胆管癌。内镜逆行胰胆管造影（ERCP）显示肝内和肝外胆管狭窄。入院时，外周血嗜酸性粒细胞计数正常；然而，入院后外周血出现快速嗜酸性粒细胞增多，这使我们怀疑为嗜酸性胆管炎（EC）。在第二次ERCP期间进行的胆管活检显示有炎症细胞和嗜酸性粒细胞浸润。根据组织病理学，该患者被诊断为EC。
