A CASE OF EOSINOPHILIC CHOLANGITIS WITH IMAGES OF THE BILE DUCT OBTAINED BY A CHOLANGIOSCOPE: A CASE REPORT

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  • IWASA Yuhei
    First Department of Internal Medicine, Gifu University Hospital.
  • IWASHITA Takuji
    First Department of Internal Medicine, Gifu University Hospital.
  • ICHIKAWA Hironao
    First Department of Internal Medicine, Gifu University Hospital.
  • MITA Naoki
    First Department of Internal Medicine, Gifu University Hospital.
  • UEMURA Shinya
    First Department of Internal Medicine, Gifu University Hospital.
  • TODA Katsuhisa
    Department of Gastroenterology, Chuno Kosei Hospital.
  • KANAYAMA Tomohiro
    Division of Pathology, Gifu University Hospital. Department of Tumor Pathology, Gifu University Graduate School of Medicine.
  • MIYAZAKI Tatsuhiko
    Division of Pathology, Gifu University Hospital.
  • SHIMIZU Masahito
    First Department of Internal Medicine, Gifu University Hospital.

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Other Title
  • 胆道鏡で胆管像を観察し得た好酸球性胆管炎の１例

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<p>A 78-year-old female who had taken prednisolone 5mg/day for neuromyelitis optica had fever and right hypochondriac pain. Laboratory evaluation showed elevated hepatobiliary enzyme level, C-reactive protein level, and proportion of eosinophils. Abdominal enhanced computed tomography showed thickening and enhancement of the bile duct wall. Endoscopic retrograde cholangiography (ERC) showed irregularity of the extrahepatic bile duct wall. Cholangioscopy showed edema and unevenness of the bile duct wall, but there was no malignant finding. Biopsy specimens of the bile duct and liver showed infiltration of eosinophils into the bile duct wall. Considering the above findings, we made the diagnosis of eosinophilic cholangitis and increased her prednisolone dose to 25mg/day. Repeat ERC and bile duct biopsy showed normal bile duct on cholangiogram and disappearance of eosinophilic infiltration into the bile duct wall. Cholangioscopy may contribute to differentiation of eosinophilic cholangitis from primary sclerosing cholangitis or bile duct cancer.</p>

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