A Case of Eosinophilic Cholecystitis Leading to the Diagnosis of Eosinophilic Granulomatosis with Polyangiitis

Abstract

A 48-year-old man with a history of adult-onset asthma, nasal polyps, eosinophilic sinusitis, and hypertension was scheduled for surgery for repeated episodes of cholelithiasis. During this time, he developed a left putaminal hemorrhage and was urgently admitted to our hospital, where emergency neuroendoscopic hematoma evacuation was performed. When laparoscopic cholecystectomy was subsequently performed, the resected specimen was found to exhibit signs of eosinophilic arteritis, mainly in the medium-sized arteries, and eosinophilic cholecystitis and eosinophilic granulomatosis with polyangiitis (EGPA) were diagnosed. EGPA may cause a variety of clinical symptoms, but its occurrence together with eosinophilic cholecystitis and cerebral hemorrhage is rare. It is important not to overlook EGPA, because it is the condition underlying eosinophilic cholecystitis, and to perform therapeutic intervention as soon as possible.