Sustained Eosinophilic Cholangitis Due to a Mite Allergy Mimicking Sclerosing Cholangitis

Intern Med. 2022 Aug 15;61(16):2477-2482. doi: 10.2169/internalmedicine.8323-21. Epub 2022 Feb 1.

Abstract

Eosinophilic cholangiopathy (EC) presents with thickening and stenosis of the bile duct wall that is histologically characterized by eosinophil infiltration. The diagnosis is often difficult. We herein report a patient who had been followed up with a diagnosis of primary sclerosing cholangitis but had a final diagnosis of EC based on eosinophilia, histological findings of bile duct and liver biopsy specimens, and a review of a previous surgical specimen of the gallbladder. Antigen tests, isolation from her house, and accidental re-exposure to the antigen revealed that the causative antigen was the mite Dermatophagoides pteronyssinus.

Keywords: eosinophilia; eosinophilic cholangiopathy; eosinophilic cholecystitis; sclerosing cholangitis.

Publication types

  • Review

MeSH terms

  • Animals
  • Bile Ducts / pathology
  • Cholangitis* / diagnosis
  • Cholangitis, Sclerosing* / diagnosis
  • Cholangitis, Sclerosing* / pathology
  • Diagnosis, Differential
  • Eosinophilia* / diagnosis
  • Eosinophilia* / pathology
  • Female
  • Humans
  • Hypersensitivity*
  • Mites*