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Eosinophilic Cholecystitis Occurred in a Patient With Refractory Eosinophilic Airway Inflammation: A Case Report

BACKGROUND: Eosinophilic cholecystitis (EC) is a rare condition that presents in a manner comparable to acute cholecystitis. The diagnosis is based on classical symptoms of cholecystitis with excessive eosinophilic infiltration within the gallbladder. EC has been reported alone or in combination wit...

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Autores principales: Kuwahara, Toshiaki, Kobayashi, Yoshiki, Yun, Yasutaka, Kanda, Akira, Asako, Mikiya, Ueki, Shigeharu, Iwai, Hiroshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6700860/
https://www.ncbi.nlm.nih.gov/pubmed/31452968
http://dx.doi.org/10.1177/2152656719869607
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author Kuwahara, Toshiaki
Kobayashi, Yoshiki
Yun, Yasutaka
Kanda, Akira
Asako, Mikiya
Ueki, Shigeharu
Iwai, Hiroshi
author_facet Kuwahara, Toshiaki
Kobayashi, Yoshiki
Yun, Yasutaka
Kanda, Akira
Asako, Mikiya
Ueki, Shigeharu
Iwai, Hiroshi
author_sort Kuwahara, Toshiaki
collection PubMed
description BACKGROUND: Eosinophilic cholecystitis (EC) is a rare condition that presents in a manner comparable to acute cholecystitis. The diagnosis is based on classical symptoms of cholecystitis with excessive eosinophilic infiltration within the gallbladder. EC has been reported alone or in combination with manifestations, such as eosinophilic gastrointestinal tract inflammation. However, association with airway inflammation in patients with EC is rare. Case Presentation: We report the case of a 65-year-old man who had refractory eosinophilic chronic rhinosinusitis with bronchial asthma. A second endoscopic sinus surgery (ESS) was performed as treatment for recurrent nasal polyps. EC occurred while inhaled corticosteroids were reduced after ESS. Pathologic examination of the excised gallbladder demonstrated submucosal infiltration with a number of eosinophils. Furthermore, immunohistostaining revealed many galectin-10-positive cells in both the gallbladder mucosa and the paranasal sinus mucosa. Galectin-10 is a major constituent of human eosinophils, also known as the Charcot–Leyden crystal protein, which has been linked with eosinophilic inflammation. Interestingly, nasal polyps were reduced without any additional treatments 1 month after the cholecystectomy. CONCLUSIONS: We experienced a rare case wherein EC onset occurred in a patient with refractory eosinophilic airway inflammation during inhaled corticosteroid tapering. Galectin-10 might help diagnose rare cases of eosinophilic inflammation in multiple organs.
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spelling pubmed-67008602019-08-26 Eosinophilic Cholecystitis Occurred in a Patient With Refractory Eosinophilic Airway Inflammation: A Case Report Kuwahara, Toshiaki Kobayashi, Yoshiki Yun, Yasutaka Kanda, Akira Asako, Mikiya Ueki, Shigeharu Iwai, Hiroshi Allergy Rhinol (Providence) Case Report BACKGROUND: Eosinophilic cholecystitis (EC) is a rare condition that presents in a manner comparable to acute cholecystitis. The diagnosis is based on classical symptoms of cholecystitis with excessive eosinophilic infiltration within the gallbladder. EC has been reported alone or in combination with manifestations, such as eosinophilic gastrointestinal tract inflammation. However, association with airway inflammation in patients with EC is rare. Case Presentation: We report the case of a 65-year-old man who had refractory eosinophilic chronic rhinosinusitis with bronchial asthma. A second endoscopic sinus surgery (ESS) was performed as treatment for recurrent nasal polyps. EC occurred while inhaled corticosteroids were reduced after ESS. Pathologic examination of the excised gallbladder demonstrated submucosal infiltration with a number of eosinophils. Furthermore, immunohistostaining revealed many galectin-10-positive cells in both the gallbladder mucosa and the paranasal sinus mucosa. Galectin-10 is a major constituent of human eosinophils, also known as the Charcot–Leyden crystal protein, which has been linked with eosinophilic inflammation. Interestingly, nasal polyps were reduced without any additional treatments 1 month after the cholecystectomy. CONCLUSIONS: We experienced a rare case wherein EC onset occurred in a patient with refractory eosinophilic airway inflammation during inhaled corticosteroid tapering. Galectin-10 might help diagnose rare cases of eosinophilic inflammation in multiple organs. SAGE Publications 2019-08-19 /pmc/articles/PMC6700860/ /pubmed/31452968 http://dx.doi.org/10.1177/2152656719869607 Text en © The Author(s) 2019 http://creativecommons.org/licenses/by-nc/4.0/ Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Report
Kuwahara, Toshiaki
Kobayashi, Yoshiki
Yun, Yasutaka
Kanda, Akira
Asako, Mikiya
Ueki, Shigeharu
Iwai, Hiroshi
Eosinophilic Cholecystitis Occurred in a Patient With Refractory Eosinophilic Airway Inflammation: A Case Report
title Eosinophilic Cholecystitis Occurred in a Patient With Refractory Eosinophilic Airway Inflammation: A Case Report
title_full Eosinophilic Cholecystitis Occurred in a Patient With Refractory Eosinophilic Airway Inflammation: A Case Report
title_fullStr Eosinophilic Cholecystitis Occurred in a Patient With Refractory Eosinophilic Airway Inflammation: A Case Report
title_full_unstemmed Eosinophilic Cholecystitis Occurred in a Patient With Refractory Eosinophilic Airway Inflammation: A Case Report
title_short Eosinophilic Cholecystitis Occurred in a Patient With Refractory Eosinophilic Airway Inflammation: A Case Report
title_sort eosinophilic cholecystitis occurred in a patient with refractory eosinophilic airway inflammation: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6700860/
https://www.ncbi.nlm.nih.gov/pubmed/31452968
http://dx.doi.org/10.1177/2152656719869607
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