Eosinophilic cholecystitis, a rare case report with a review of the literature

Document Type: Case Report

Authors

Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

The clinical presentation of eosinophilic cholecystitis (EC) is similar to that of typical cholecystitis, and its common symptoms are right upper quadrant (RUQ) tenderness and Murphy’s sign. In the literature, some reported cases have been associated with the hyper-eosinophilic syndrome(HES), infections, drugs, and parasitosis; however, its etiology has often been unknown.
We report a 32-year-old woman presented with two-day RUQ pains and radiation to the right shoulder. A clinical picture of severe acute cholecystitis was recorded, and the patient underwent open cholecystectomy. Microscopically, we observed an edematous wall with occasional acute and chronic inflammatory cells and predominantly eosinophils. Due to peripheral eosinophilia, we recommended the patient to be examined for the hyper-eosinophilic syndrome, eosinophilic gastroenteritis, and parasitosis. In follow up, parasitic gastroenteritis was diagnosed, and the patent underwent proper treatment.
Since the EC signs are similar to those of typical cholecystitis, it should not be considered a separate entity. The significance of the EC diagnosis is that it can be associated with other diseases, and this should be considered when it is diagnosed.

Keywords


1-      Keyal NK, Adhikari P, Baskota BD, Rai U, Thakur A. Eosinophilic Cholecystitis presenting with Common Bile Duct Sludge and Cholangitis: A Case Report. Journal of the Nepal Medical Association. 2020 Mar 1;58(223).
2-      Kuwahara T, Kobayashi Y, Yun Y, Kanda A, Asako M, Ueki S, Iwai H. Eosinophilic Cholecystitis Occurred in a Patient With Refractory Eosinophilic Airway Inflammation: A Case Report. Allergy & Rhinology. 2019 Aug;10:2152656719869607.
3-      Hasan A, Nafie K. Eosinophilic cholecystitis: a rare cause of acute cholecystitis ‘case report’. Al-Azhar Assiut Medical Journal. 2019 Oct 1;17(4):417.
4-      Caesar J, Jordan M, Hills M. Case report: A rare case of eosinophilic cholecystitis presenting after talc pleurodesis for recurrent pneumothorax. Respiratory medicine case reports. 2017 Jan 1;20:16-8.
5-      Ranaee R, Khosravi M, Vosough Z. A Rare Case of Eosinophilic Cholecystitis Presenting in a Patient with Thalassemia Intermedia; a Case Report. Journal of Advances in Medical and Biomedical Research. 2019;27(121):54-7.
6-      Dwivedi T, Chavan R. Eosinophilic Cholecystitis with Lipomatosis: a rare case report and review of literature. Annals of Pathology and Laboratory Medicine. 2016 Feb 25;3(1):C23-26.
7-      Khan S, Hassan MJ, JairaJPuri ZS, Jetley S, Husain M. Clinicopathological study of eosinophilic cholecystitis: five year single institution experience. Journal of clinical and diagnostic research: JCDR. 2017 Aug;11(8):EC20.
8-      Ramesh K, Harpal S, Chakma S, Kaur N, DEEPIKA D. ASCARIASIS AS A CAUSE OF ACALCULUS EOSINOPHILIC CHOLECYSTITIS-A RARE CASE REPORT. International Journal of Clinical and Biomedical Research. 2016 Jan 29:54-6.
9-      Garzón GL, Jaramillo BL, Valero HJ, Quintero CE. Eosinophilic cholecystitis in children: case series. Journal of Pediatric Surgery. 2020 Jun 3.
10-   Jagtap SV, Jokhi CD, Shukla D, Jagtap SS, Kulkarni SR. Idiopathic eosinophilic cholecystitis with Cholelithiasis-a rare histopathological variant. Asian Pac J Health Sci.. 2017 Mar 30;4(1):217-9.