A Case of Eosinophilic Cholecystitis Associated with Churg-Strauss Syndrome Treated by Laparoscopic Cholecystectomy

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  • 手術を施行したChurg-Strauss症候群に伴う好酸球性胆嚢炎の1例
  • 症例 手術を施行したChurg-Strauss症候群に伴う好酸球性胆囊炎の1例
  • ショウレイ シュジュツ オ シコウ シタ Churg-Strauss ショウコウグン ニ トモナウ コウサンキュウセイ タンノウエン ノ 1レイ

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Abstract

A 29-year-old man with a history of fever and abdominal pain was referred to our hospital for further examination and treatment. He had a history of bronchial asthma and vasculitis. Blood test results on admission showed elevation of the absolute eosinophil count (36900μ/L), and of the serum hepatic and biliary enzyme levels. The patient was diagnosed as having Churg-Strauss syndrome (CSS) with complicating acute acalculous cholecystitis. The eosinophil count decreased transiently following intravenous administration of a steroid, however, it rose again when the steroid dose was tapered. In addition, the cholecystitis could not be controlled by conservative medical therapy. Therefore, laparoscopic cholecystectomy was performed, followed by steroid pulse therapy for the CSS. The treatment was followed by a dramatic improvement of the clinical symptoms. The patient had no recurrence of the CSS for at least 1 year after discharge.<BR>CSS is a systemic disorder characterized by allergic diathesis, hypereosinophilia and vasculitis. Eosinophilic cholecystitis is a rare complication of CSS. We present the case of a patient diagnosed as having CSS with acalculous cholecystitis who was treated by laparoscopic cholecystectomy and subsequent steroids pulse therapy.

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