A patient with asymptomatic primary biliary cirrhosis associated with eosinophilic infiltration and peripheral eosinophilia improved by the administration of ursodeoxycholic acid.

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A 49-year-old male was admitted complaining of persistent cough, sputum and fever. The chest film examined on admission showed an infiltrative shadow in the right middle lung field. Blood tests revealed elevations of the ductal enzymes and a peripheral eosinophilia. However, the pulmonary infiltration with eosinophilia syndrome and drug-induced liver injury were negated by the absence of eosinophils in the lavaged fluids and in the lung specimens obtained by the transbronchial approach and by the negative lymphocyte-stimulation test against drugs prescribed for the respiratory symptoms. Further examinations revealed a positive anti-mitochondrial antibody and an increase in its M2 fraction measured at 46.7U/m/. The diagnosis of primary biliary cirrhosis was suspected and was ascertained as Scheuer's stage I by the wedge liver biopsy, showing chronic non-suppurative destructive cholangitis (CNSDC) in the enlarged portal areas, which were markedly infiltrated with lymphocytes and plasma cells together with eosi ophils. The eosinophilic infiltration was predominantly observed around the injured bile ducts. After the diagnosis was ascertained, ursodeoxycholic acid was given at a dose of 600 mg a day. Simultaneous improvements in the ductal enzymes and peripheral eosinophilia were observed one month later. The repeat biopsy carried out with an interval of 7 weeks after initiation of the treatment revealed only minor cellular infiltration without eosinophils and absent CNSDC.
社団法人日本肝臓学会の論文

A patient with asymptomatic primary biliary cirrhosis associated with eosinophilic infiltration and peripheral eosinophilia improved by the administration of ursodeoxycholic acid.

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