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由尘螨过敏引起的持续性嗜酸性胆管炎,类似于硬化性胆管炎。

Sustained Eosinophilic Cholangitis Due to a Mite Allergy Mimicking Sclerosing Cholangitis.

机构信息

Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Japan.

Department of Gastroenterology, Hakodate Goryoukaku Hospital, Japan.

出版信息

Intern Med. 2022 Aug 15;61(16):2477-2482. doi: 10.2169/internalmedicine.8323-21. Epub 2022 Feb 1.

Abstract

Eosinophilic cholangiopathy (EC) presents with thickening and stenosis of the bile duct wall that is histologically characterized by eosinophil infiltration. The diagnosis is often difficult. We herein report a patient who had been followed up with a diagnosis of primary sclerosing cholangitis but had a final diagnosis of EC based on eosinophilia, histological findings of bile duct and liver biopsy specimens, and a review of a previous surgical specimen of the gallbladder. Antigen tests, isolation from her house, and accidental re-exposure to the antigen revealed that the causative antigen was the mite Dermatophagoides pteronyssinus.

摘要

嗜酸性胆管病(EC)表现为胆管壁增厚和狭窄,组织学特征为嗜酸性粒细胞浸润。诊断往往具有挑战性。本文报告了 1 例患者,最初诊断为原发性硬化性胆管炎,但根据嗜酸性粒细胞、胆管和肝活检标本的组织学发现,以及对先前胆囊手术标本的回顾性检查,最终诊断为 EC。抗原检测、从其住所中分离以及偶然再次接触抗原表明,致病抗原是尘螨(Dermatophagoides pteronyssinus)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba83/9449603/cc678b8a090e/1349-7235-61-2477-g001.jpg

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