Abstract
Eosinophilic cholecystitis is a rare disease characterized by transmural leukocyte infiltration composed of more than 90% eosinophils. Eosinophilic cholecystitis is clinically indistinguishable from ordinary cholecystitis, and as a rule it leads to cholecystectomy. We report a case of idiopathic eosinophilic cholecystitis treated with steroids. A 75-year-old woman presented with a classic history of acute cholecystitis and a peripheral eosinophilia of 41.8%. There was no evidence of allergy or parasitic infestation. An abdominal ultrasonography and computed tomography (CT) scan showed an edematous, thickened gallbladder wall, but no gallstones. There was no evidence of eosinophilic infiltration in other organs. Cholecystectomy was not performed because the patient refused surgical management. However, fever, abdominal pain, and peripheral eosinophilia persisted despite antibiotic and conservative therapy. Therefore, we attempted treatment with prednisolone. A week later, the symptoms disappeared and the peripheral eosinophilia normalized.
호산구성 담낭염은 일반적인 담낭염과 증상 및 검사 소견에서 명확히 구분되지 않아 대부분 담낭 절제술로 진단과 치료가 동시에 이루어진다. 하지만 본 증례처럼 특별한 호산구 증가증의 원인이 없는 호산구성 담낭염이 의심되면 담낭천공, 패혈증 등의 응급 수술을 요하는 경우를 제외하고 담낭 절제술에 앞서 스테로이드 사용을 신중히 고려해 볼 수 있겠다.