Eosinophils and PSC

[Guest guest]

Hi

Did anyone have a high level of eosinophils as part of their diagnosis

for PSC? My husband's high level has been stumping the doctors and we

want to make sure that level will come down, as it remaining high is

dangerous.

Thanks!

[Guest guest]

Hi " trinaldi " ;

I've read that elevated eosinophils can occassionally be associated

with PSC. But other resports suggest that high eosinophils might be

causes of secondary sclerosing cholangitis (e.g. eosinophillic and/or

mast cell cholangitis, and/or hypereosinophilic sclerosing

cholangitis). Some papers describing these conditions are as follows.

_______________

Hepatology. 2006 Nov;44(5):1063-74.

Sclerosing cholangitis: a focus on secondary causes.

Abdalian R, Heathcote EJ.

Department of Medicine, University Health Network, Toronto Western

Hospital, University of Toronto, Toronto, Ontario, Canada.

Secondary sclerosing cholangitis (SSC) is a disease that is

morphologically similar to primary sclerosing cholangitis (PSC) but

that originates from a known pathological process. Its clinical and

cholangiographic features may mimic PSC, yet its natural history may be

more favorable if recognition is prompt and appropriate therapy is

introduced. Thus, the diagnosis of PSC requires the exclusion of

secondary causes of sclerosing cholangitis and recognition of

associated conditions that may potentially imitate its classic

cholangiographic features. Well-described causes of SSC include

intraductal stone disease, surgical or blunt abdominal trauma, intra-

arterial chemotherapy, and recurrent pancreatitis. However, a wide

variety of other associations have been reported recently, including

autoimmune pancreatitis, portal biliopathy, eosinophillic and/or mast

cell cholangitis, hepatic inflammatory pseudotumor, recurrent pyogenic

cholangitis, primary immune deficiency, and AIDS-related

cholangiopathy. This article offers a comprehensive review of SSC.

PMID: 17058222.

_______________

Hepatogastroenterology. 2000 Mar-Apr;47(32):359-61.

Hypereosinophilic sclerosing cholangitis: findings using half-Fourier

magnetic resonance imaging.

al-Abdulla NA, Schulick RD, Regan F.

Department of Surgery, s Hopkins School of Medicine, Baltimore,

land 21205, USA.

Hypereosinophilic sclerosing cholangitis is a rare disease caused by

eosinophilic infiltration of the gallbladder and biliary tract seen in

the idiopathic hypereosinophilic syndrome. We report a 42-year-old

woman who presented with symptoms of cholecystitis and obstructive

cholangitis. Imaging with magnetic resonance cholangiography using a

half-Fourier spinecho sequence, we were able to visualize rapidly and

non-invasively a severely abnormal gallbladder, evidence of liver

parenchymal inflammation, and biliary duct dilatation. PMID: 10791189

_______________

Am J Gastroenterol. 1993 Oct;88(10):1764-9.

Eosinophilic sclerosing cholangitis associated with hypereosinophilic

syndrome.

Grauer L, Padilla VM 3rd, Bouza L, Barkin JS.

Division of Gastroenterology, University of Miami, School of

Medicine/Mt. Sinai Medical Center, Miami Beach, Florida.

We describe the case of a 41-yr-old man who presented with signs and

symptoms of cholestasis including abdominal pain, jaundice, and fever,

with peripheral eosinophilia of 10% and bone marrow eosinophilia. Liver

biopsy revealed an eosinophilic infiltrate and an ERCP demonstrated

bile duct changes, compatible with primary sclerosing cholangitis

(PSC). After treatment with prednisone and ursodeoxycholic acid, the

patient's liver profile tests returned to normal, the ERCP changes

resolved, and all symptoms disappeared. A literature review has not

shown any previous reports of reversible sclerosing cholangitis,

secondary to eosinophilic infiltration. The purpose of this report is

to describe eosinophilic cholangitis, an entity that mimics PSC in the

context of the hypereosinophilic syndrome. PMID: 8213721.

_______________

It seems like it is difficult to tell PSC apart from eosinophilic

cholangitis associated with hypereosinophilic syndrome.

I hope this information may help your husband's doctors got to the

cause of his high level of eosinophils and (P)SC.

Best regards,

Dave

(father of (21); PSC 07/03; UC 08/03)

> Did anyone have a high level of eosinophils as part of their

diagnosis for PSC? My husband's high level has been stumping the

doctors and we want to make sure that level will come down, as it

remaining high is dangerous. Thanks!

[Guest guest]

trinaldi1 wrote:

>

> Did anyone have a high level of eosinophils as part of their diagnosis

> for PSC? My husband's high level has been stumping the doctors and we

> want to make sure that level will come down, as it remaining high is

> dangerous.

On my lab work, there are 3 different items and I don't know which one

you might be referring to specifically. There are:

Eosinophil percent (0.0-4.0)% -- mine tend to stay elevated,

around 4.7%

Eosinophil Absol. (0.0-0.4) -- mine stay steady at 0.2

Eosinophil (0-4)% -- mine stay around 3

For what it's worth, my dr. has never been concerned about the elevation

in the eosinophil percent category, but I honestly don't know the

difference between these 3 or what implications an abnormal value might

have.

Perhaps someone else can explain (in simple terms, please!! LOL!)

Regards,

Carolyn B. in SC

[Guest guest]

ok, regarding Eosinophils. I'm so excited I might be able to answer part of your question anyway. They are just a type of white blood cell. They are usually around 1-3% of your total white blood cell count. The absolute is totally related to your white blood cell count. for example, if your Eos% is 1% & your WBC is 10.0, then you would: 10.0 WBC x 0.01 (Eos%) ___________ 0.1 = Absolute Eosinophils. normal is <0.45 Absolute Eosinophils Eos can increase in different illnesses, such as hay fever, bronchial asthma, recovery from bacterial infections. They can also increase in some cases of stress (such as shock) burns & severe infections. However, i can no answer your question if they increase durring PSC. Just thought i'd help you understand what an Eosinophil was. Any more lab questions, i'd be

happy to hear... & look up if i don't know it. Tammy (wife of Chad, Kokomo, IN) Carolyn B wrote: trinaldi1 wrote:> > Did anyone have a high level of eosinophils as part of their diagnosis> for PSC? My husband's high level has been stumping the doctors and we> want to make sure that level will come down, as it remaining high is> dangerous.On my lab work, there are 3 different items and I don't know which one you might

be referring to specifically. There are:Eosinophil percent (0.0-4.0)% -- mine tend to stay elevated, around 4.7%Eosinophil Absol. (0.0-0.4) -- mine stay steady at 0.2Eosinophil (0-4)% -- mine stay around 3For what it's worth, my dr. has never been concerned about the elevation in the eosinophil percent category, but I honestly don't know the difference between these 3 or what implications an abnormal value might have.Perhaps someone else can explain (in simple terms, please!! LOL!)Regards,Carolyn B. in SC

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[Guest guest]

tammy VanCamp wrote:

>

> ok, regarding Eosinophils. I'm so excited I might be able to answer

> part of your question anyway. They are just a type of white blood

> cell. They are usually around 1-3% of your total white blood cell

> count.

Thanks Tammy! That explains why my percetage is always high. My total

white count is always low and so the eosinophils make up a larger

percentage of the total than they otherwise would.

Regards,

Carolyn B. in SC

[Guest guest]

Sorry for my english. In my case I had a high level of eosinophils

after a jaundice, before hepatic biopsy and before diagnosis; my doctor

says that is an important sign for an autoimmune disease, for PSC as

for autoimmune hepatitis. Now my bloody levels are ALL normal only with

ursodiol

Elisabetta (Roma)

diagnosis

> for PSC? My husband's high level has been stumping the doctors and

we

> want to make sure that level will come down, as it remaining high is

> dangerous.

> Thanks!

>