Pancreas Vol. 5 , No. 1, pp. 104-107 0 1990 Raven Press, Ltd., New York

Case Report

Eosinophilic Pancreatitis: Report of a Case C. Bastid, J. Sahel, R. Choux, M. J. Payan, and H. Sarles Service de Gastroente‘rologie, Hbpital Sainte-Marguerite, Marseille, France

Summary: A case of relapsing pancreatitis in a young man is presented. Stenosis of the main duct and cystic lesions of the tail of the pancreas were shown by ultrasonography, CT scan, and endoscopic retrograde cholangiopancreatography (ERCP). After a wrong diagnosis of cancer, the pathological examination demonstrated an eosinophilic infiltration of the pancreatic tail, spleen, lymph nodes, and spleen flexure of the colon. After treatment with oral cromoglycate, the previously increased rate of polynuclear eosinophils in blood returned to normal. Similar observations were found in the medical literature. Key Words: Pancreas-Pancreatitis-Polynuclear eosinophilsERCP.

Eosinophilic infiltration of the digestive tract is a rare condition, with only 200 cases reported in the literature up to 1975. An allergic origin has been suggested (1-3). Two types are distinguished: eosinophilic gastroenteritis, either diffuse or localized ( 4 3 , sometimes with an associated blood eosinophilia (6), and the idiopathic hypereosinophilic syndrome, which fulfills precise diagnostic criteria (79): blood eosinophilia of 1,500 cells/mm3 or more persisting for more than 6 months, absence of any known cause, and multivisceral involvement. Borderline forms have been described (10). Eosinophilic infiltration of the pancreas is extremely rare. We found four cases in the literature, three combined with eosinophilic gastroenteritis (1 1-13) and one in an idiopathic hypereosinophilic syndrome (10). We report here the fifth case of pancreatic involvement in eosinophilic infiltration of the digestive tract. A 21-year-old man was admitted to the hospital on December 2, 1984 for pancreatic investigation.

Three months previously he had suffered an episode of epigastric pain with posterior radiation, relieved by bending forward and disappearing spontaneously within a few hours. Upper gastrointestinal endoscopy revealed two small, superficial duodenal ulcers, which were treated with cimetidine and antacids. Two further identical attacks led to a second endoscopy, which was normal. Serum amylase levels were twice the upper limit of normal. There was also an eosinophilia of 720 cells/mm3in a total of 8,000 white cells (normal value:

Eosinophilic pancreatitis: report of a case.

A case of relapsing pancreatitis in a young man is presented. Stenosis of the main duct and cystic lesions of the tail of the pancreas were shown by u...
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