Abstract
Symptoms of cholestasis, including epigastralgia, fever, and jaundice, with marked increases in peripheral eosinophils and serum IgE in a 20-year-old man are reported here. Endoscopic retrograde cholangio-pancreatography (ERCP) detected constrictions of the bile ducts, compatible with primary sclerosing cholangitis (PSC). The symptoms and blood parameters of liver dysfunction were associated with the degree of eosinophilia and high serum IgE levels. During corticosteroid therapy, all of these parameters improved, and morphologic improvements of the bile ducts were also observed. The pathogenesis of PSC may be explained, in part, by the concept of hypereosinophilic syndrome or allergic reaction.
Similar content being viewed by others
References
LaRusso NF, Wiesner RH, Ludwig J, et al. Current concepts: Primary sclerosing cholangitis. N Engl J Med 1993;310:899–903.
Butler TW, Feintuch TA, Caine WP Jr. Eosinophilic cholangitis, lymphadenopathy and peripheral eosinophilia: A case report. Am J Gastroenterol 1988;80:572–579.
Mir-Madjillesi SH, Sivak HV, Farmer R. Hypereosinophilia, ulcerative colitis and bile duct carcinoma. Am J Gastroenterol 1986;81:483–485.
Neeman A, Kadish U. Marked eosinophilia in a patient with primary sclerosing cholangitis. Am J Med 1987;83:378–379.
Sheurlen M, Mork H, Weber P. Hypereosinophilic syndrome resembling chronic inflammatory disease with primary sclerosing cholangitis. J Clin Gastroenterol 1992;14:59–63.
Grauer L, Padilla VM, Bouza L, et al. Eosinophilic sclerosing cholangitis associated with hypereosinophilic syndrome. Am J Gastroenterol 1993;88:1764–1769.
Kagawa T, Suematsu M, Miura S, et al. A case of primary sclerosing cholangitis with marked eosinophilia (in Japanese). Sogo Rinsho (Clinic all-round) 1988;9:2339–2342.
Fausi AS, Harley JB, Roberts WC, et al. The idiopathic hypereosinophilic syndrome. Clinical, pathophysiologic, and therapeutic considerations. Ann Intern Med 1982;97:78–92.
Schwartz SY, Dale WA. Primary sclerosing cholangitis: Review and report of six cases. Arch Surg 1958;77:439–451.
Thorpe MEC, Scheuer PJ, Sherlock S. Primary sclerosing cholangitis, biliary tree, and ulcerative cholitis. Gut 1967;8:435–448.
La Russo NF, Wiesner RH. Clinicopathologic features of the syndrome of primary sclerosing cholangitis. Gastroenterology 1980;79:200–206.
Gross JB Jr, Beaver SJ, McCall JT, et al. Abnormalities in tests of copper metabolism in primary sclerosing cholangitis: Prognostic and diagnostic significance. Gastroenterology 1983;84:1176.
Bodenheimer HC Jr, Larusso NF, Thayer WR Jr, et al. Elevated cirsulating immune complexes in primary sclerosing cholangitis. Hepatology 1983;3:150–154.
McFarlane IG, Wojcicka BM, Tsantoulas DC, et al. Leukocyte migration inhibition in response to biliary antigens in primary biliary cirrhosis, sclerosing cholangitis, and other chronic liver disease. Gastroenterology 1979;76:1333–1340.
Chapman RW, Varghese Z, Gaul R, et al. Association of primary sclerosing cholangitis with HLA-B8. Gut 1983;24:38–41.
Parrillo JE, Fausi AS, Wolff SM. Therapy of the hypereosinophilic syndrome. Ann Intern Med 1978;89:167–172.
Foong A, Scholes JV, Gleich GJ, et al. Eosinophil-induced chronic active hepatitis in the idiopathic hypereosinophilic syndrome. Hepatology 1991;13:1090–1094.
Wong DTW, Elovic A, Matossian L, et al. Eosinophils from patients with blood eosinophilia express transforming growth factor BI. Blood 1991;78:2702–2707.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Shimomura, I., Takase, Y., Matsumoto, S. et al. Primary sclerosing cholangitis associated with increased peripheral eosinophils and serum IgE. J Gastroenterol 31, 737–741 (1996). https://doi.org/10.1007/BF02347627
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02347627