一例嗜酸性胰腺炎合并嗜酸性结肠炎病例

A Case of Simultaneous Eosinophilic Pancreatitis and Eosinophilic Colitis.

作者信息

Kubo Kimitoshi, Ashida Issei, Kimura Noriko

机构信息

Department of Gastroenterology, National Hospital Organization Hakodate Medical Center, Hakodate, JPN.

Department of Gastroenterology, Hakodate Medical Center, Hakodate, JPN.

出版信息

Cureus. 2025 Apr 30;17(4):e83238. doi: 10.7759/cureus.83238. eCollection 2025 Apr.

Abstract

A 24-year-old man presented with abdominal pain and bloody diarrhea. Computed tomography (CT) demonstrated a diffusely enlarged pancreas with increased attenuation of the surrounding peripancreatic fat. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) was performed on the hypoechoic area in the pancreatic head, and a histological examination of an EUS-FNA specimen revealed marked eosinophilic infiltration (≥20/HPF). In addition, colonoscopy (CS) revealed redness, erosion, and edema extending from the cecum to the ascending colon, and a CS biopsy revealed marked eosinophilic infiltration (≥20/HPF). The patient was thus diagnosed with simultaneous eosinophilic pancreatitis (EP) and eosinophilic colitis (EC) and was treated with prednisolone. His symptoms improved within a few days, and CT performed two weeks later showed improvement in the diffusely enlarged pancreas, allowing prednisolone to be gradually tapered. The present case demonstrates the importance of pathological examinations in the differential diagnosis of EP and its likely complications (e.g., EC in this case).

摘要

一名24岁男性因腹痛和血性腹泻就诊。计算机断层扫描(CT)显示胰腺弥漫性肿大,胰腺周围脂肪衰减增加。对胰头低回声区进行了内镜超声引导下细针穿刺活检(EUS-FNA),EUS-FNA标本的组织学检查显示有明显的嗜酸性粒细胞浸润(≥20/HPF)。此外,结肠镜检查(CS)显示从盲肠至升结肠有发红、糜烂和水肿,CS活检显示有明显的嗜酸性粒细胞浸润(≥20/HPF)。因此,该患者被诊断为同时患有嗜酸性胰腺炎(EP)和嗜酸性结肠炎(EC),并接受了泼尼松龙治疗。他的症状在几天内有所改善,两周后进行的CT显示弥漫性肿大的胰腺有所好转,泼尼松龙得以逐渐减量。本病例证明了病理检查在EP鉴别诊断及其可能并发症(如本例中的EC)中的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d58/12123552/bcac85516c5a/cureus-0017-00000083238-i01.jpg

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