Recurrent severe acute hepatitis caused by hypereosinophilic syndrome associated with elevated serum immunoglobulin G4 levels

被引：13

作者：

Aoyama T. ^{[1
]}

Matsumoto T. ^{[2
]}

Uchiyama A. ^{[1
]}

Kon K. ^{[1
]}

Yamashina S. ^{[1
]}

Suzuki S. ^{[1
]}

Ikejima K. ^{[1
]}

Yao T. ^{[3
]}

Kuwatsuru R. ^{[4
]}

Watanabe S. ^{[1
]}

机构：

[1] Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo

[2] Department of Clinical Pathology, Juntendo University Nerima Hospital, Tokyo

[3] Department of Human Pathology, Juntendo University School of Medicine, Tokyo

[4] Department of Radiology, Juntendo University School of Medicine, Tokyo

来源：

Clinical Journal of Gastroenterology | 2014年 / 7卷 / 6期

关键词：

Acute hepatitis; Eosinophilia; IgG4;

D O I：

10.1007/s12328-014-0532-0

中图分类号：

学科分类号：

摘要：

A 46-year-old male was admitted to our hospital with severe acute hepatitis, hypereosinophilia, and serum immunoglobulin G4 (IgG4) elevation. Plasma exchange was performed, and he was treated by prednisolone; however, his hepatitis recurred twice over the following twelve months. Transjuglar liver biopsy was performed at the third onset, which demonstrated extensive hepatocyte necrosis, congestion, and severe eosinophil infiltration. We diagnosed hypereosinophilic syndrome (HES)-related hepatitis. Although no cholangitis was detected by imaging and pathological diagnosis, IgG4-positive cells were detected in the liver and bone marrow. Furthermore, the elevation of serum IgG4 levels was associated with the eosinophil count and his clinical condition. After the addition of azathioprine to his treatment regimen, no reoccurrence was observed. IgG4-positive cells may have contributed to the severity and refractoriness of this recurrent acute HES-related hepatitis. © 2014, Springer Japan.

引用

页码：516 / 522

页数：6

共 19 条

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