Calculous Eosinophilic Cholecystitis in Immunocompetent Patient

Abstract

We report a case of calculous eosinophilic cholecystitis (EC) without symptoms suggesting the presence of Eosinophilic Granulomatosis with Polyangiitis (EGPA). A 68 years old male immunocompetent, presented to the Emergency Department (ED), with a picture of acute calculous cholecystitis. Upon his presentation, laboratory investigations showed no leukocytosis nor elevation of eosinophils count in blood serum, however, neutrophils count in serum was found to be high (76%, normal range up to 70%), then two days later patient underwent laparoscopic cholecystectomy. His final histopathology showed a picture of Eosinophilic Cholecystitis, post-operative detailed history, laboratory test including Antinuclear Antibody (ANA), Antineutrophil cytoplasmic Antibody (ANCA), immunoglobulin, and chest X-ray ruled out the possibility of the systemic disease (EGPA, Churg Strauss syndrome), and confirmed that the eosinophilia was localized to the gallbladder, which caused the picture of acute cholecystitis, and was treated sufficiently with the laparoscopic cholecystectomy.