Watanabe H, Ohira H, Kuroda M, Takagi T, Ishikawa H, Nishimaki T, Kasukawa R, Takahashi K
Department of Internal Medicine II, Fukushima Medical College, Japan.
J Gastroenterol. 1995 Aug;30(4):524-8. doi: 10.1007/BF02347572.
A 16-year-old boy was diagnosed as having primary sclerosing cholangitis (PSC), based on retrograde cholangiography showing mixed features of narrowing and dilatation of the common hepatic and intrahepatic bile ducts. However, periductal fibrosis was not observed in the needle biopsy liver specimen. The liver biopsy specimen obtained 11 years previously, at the onset of the disease had disclosed a marked infiltration of eosinophils in the portal tract with eosinophilic catinonic protein immunostaining, with marked eosinophilia (54%) being noted. In Japanese reports, eosinophilia of more than 7% was reported in 13 of 32 (40.6%) PSC patients. However, the early stage of PSC, with marked eosinophilia and eosinophilic infiltration in the liver, such as in the present case, has rarely been reported. The findings in this case suggest that eosinocytes are related to the pathogenesis of PSC.
一名16岁男孩被诊断为原发性硬化性胆管炎（PSC），逆行胆管造影显示肝总管和肝内胆管有狭窄和扩张的混合特征。然而，在经皮肝穿刺活检标本中未观察到导管周围纤维化。11年前疾病发作时获取的肝活检标本显示，门管区有明显的嗜酸性粒细胞浸润，嗜酸性阳离子蛋白免疫染色阳性，嗜酸性粒细胞增多明显（54%）。在日本的报告中，32例PSC患者中有13例（40.6%）报告嗜酸性粒细胞增多超过7%。然而，如本例这样在PSC早期出现明显嗜酸性粒细胞增多和肝脏嗜酸性粒细胞浸润的情况鲜有报道。该病例的发现提示嗜酸性粒细胞与PSC的发病机制有关。
