Eosinophilic Pancreatitis Diagnosed With Endoscopic Ultrasound

Kakodkar, Samir; Omar, Haniza; Cabrera, Julio; Chi, Kenneth

doi:10.14309/crj.2015.71

Cited by 16 publications

(16 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, cholecystectomy was performed in 2 patients [24,29], gastrojejunostomy and tube cholecystotomy in one due to duodenal obstruction [28], and multiple pancreatic duct stents were placed for pancreatic duct leak in another one [24], while en block distal pancreatectomy and splenectomy followed by Cromoglycate administration [30] was performed in a patient with cystic lesion of the tail. In addition to biliary stenting (2/20) and surgery (1/20), prednisone, often 40 mg/day, was initiated only in 5/20 patients (25%) [12,28,32,34,36].…”

Section: Patients With Eosinophilic Pancreatitismentioning

confidence: 99%

“…/20) of the patients had increased eosinophil blood count and 4 of them had either mild allergic symptoms (1/20), shellfish allergy (1/20) or asthma (2/20)[24][25][26][27], while increased IgE levels were reported only in 5/20 patients.Abdominal pain was the most frequent symptom (15/20, 75%)[12,[24][25][26][28][29][30][31][32][33][34][35], followed by nausea/vomiting (5/20, 25%), weight loss (2/20, 10%), diarrhea (1/20, 5%) and jaundice in 7/20 patients. Apart from one patient who accused recurrent abdominal pain during the previous 18 years, in the rest of the cases pain started shortly before hospital admission.At the moment of diagnosis pancreatic enzymes above the upper limit of normal were reported only in 7 patients (47%) with abdominal pain.Pancreaticascites (1/20), dyspnea caused by peritoneal and pleural effusion (1/20), diabetes mellitus (2/20) and lipodystrophy (1/20) were also reported.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Eosinophilic pancreatitis versus pancreatitis associated with eosinophilic gastroenteritis – a systematic review regarding clinical features and diagnosis

Pinte

Băicuș

2019

Romanian Journal of Internal Medicine

View full text Add to dashboard Cite

Background. Over the past years, eosinophil infiltration involving the gastrointestinal tract and pancreas leading to eosinophilic pancreatitis, eosinophilic gastroenteritis and hypereosinophilic syndrome has been reported in the literature. We aimed to analyze and compare the features involving patients with eosinophilic pancreatitis and pancreatitis associated with eosinophilic gastroenteritis and to determine if there is a connection between the two disorders or if they in fact meet the diagnostic criteria for hypereosinophilic syndrome. Material and methods. The following search was performed in March 2019 on PubMed (MEDLINE) database using the medical terms “pancreatitis”, “eosinophilic pancreatitis”, “eosinophilic gastroenteritis” and “hypereosinophilic syndrome”. Results. The search revealed 119 publications from 1970 onwards. A total of 83 papers were excluded, and the remaining 36 publications, consisting in case reports and case series, were analyzed. From 45 patients, 20 subjects with eosinophilic gastroenteritis developed pancreatitis, 20/45 had eosinophilic pancreatitis, and 5/45 hypereosinophilic syndrome involving the pancreas. There was no significant difference regarding clinical, laboratory and imaging features between the three groups, despite the multiple theories that explain the association of pancreatic and gastrointestinal eosinophilic infiltration. Although there was a strong resemblance between the three groups, histological evidence of eosinophilic gastrointestinal infiltration guided the treatment towards a less invasive way, while subjects with eosinophilic pancreatitis underwent pancreatic surgery to exclude potentially malignant lesions. Conclusion. Although there are various theories that explain pancreatitis development in patients with eosinophilic gastroenteritis, hypereosinophilia diagnostic work-up should be taken into account in all patients with high number of blood eosinophils, even in those with eosinophilic pancreatitis in order to establish the diagnosis using a minimally invasive approach and to apply an adequate treatment.

show abstract

Section: Patients With Eosinophilic Pancreatitismentioning

confidence: 99%

mentioning

confidence: 99%

Eosinophilic pancreatitis versus pancreatitis associated with eosinophilic gastroenteritis – a systematic review regarding clinical features and diagnosis

Pinte

Băicuș

2019

Romanian Journal of Internal Medicine

View full text Add to dashboard Cite

show abstract

“…In normal conditions, the mucosa of the digestive tract is the only organ harboring a substantial number of eosinophils, which, if needed, get activated and exert several effector and immunoregulatory functions [26]. Although, in healthy pancreas no baseline eosinophils are reported; however, in several cases the presence of induced eosinophils in the patients with pancreatitis are reported and the condition is termed as "Eosinophilic Pancreatitis" [27][28][29]. Most recently the detection of induced IL-5 has been reported in experimental model of chronic pancreatitis [30] that indicates eosinophils may be a critical immune cells in promoting pancreatitis pathogenesis.…”

Section: Eosinophilsmentioning

confidence: 99%

“…Eosinophilic pancreatitis (EP) is rarely occurring disorder and several reports indicate that eosinophilic pancreatitis is frequently diagnosed only after "false positive" pancreatic resection for suspected pancreatic tumor and it can mimic a pancreatic neoplasm [28,29,33]. Juniper in 1955 [34] has shown for the first time peripheral blood eosinophilia in chronic pancreatitis patient and then, several reports based on eosinophilic pancreatitis were published [35][36][37][38].…”

Section: Eosinophilic Pancreatitismentioning

confidence: 99%

Immunological Responses Involved In Promoting Acute and Chronic Pancreatitis

Manohar¹,

Verma²,

Venkateshaiah³

et al. 2017

Clin Immunol Res

View full text Add to dashboard Cite

Pancreatitis is the inflammatory disease of pancreas induced by unusual food habit, alcohol abuse, and genetic defect in cationic trypsinogen gene. Initial occurrences are termed as acute pancreatitis and if proper consideration is not provided then leads to the chronic pancreatitis followed by fibrosis. During the complex process of pancreatitis several pro-inflammatory cells, cytokines and chemokines play very critical role in initiation and progression of the disease. The etiology of the eosinophilic pancreatitis (EP) is poorly understood and role of inflammatory cytokines, immune cells and its mediators are not well explored. The factors involved in promoting chronic pancreatitis from acute pancreatitis are completely unidentified that progresses into the pancreatic fibrosis and further leads to the pancreatic malignancy. Therefore, an urgent need to understand the immune mechanism involved in promoting pancreatitis. The current review provides a comprehensive understanding and crucial role of complex interwoven network of various immune related cell types such as neutrophils, eosinophils, mast cells, pancreatitis; that might be useful for scientists and physician to focus on the role of particular cell types and their associated mediators in pancreatitis pathogenesis. We hope that better understanding on the mechanism of the development of pancreatitis will help to design specific therapy to treat pancreatitis. Therefore, attention should be given to identify the focused immune mechanism that promotes pancreatitis in human.

show abstract

“…Several clinical reports have indicated induced eosinophils in the biopsies of pancreatitis patients that are termed as “eosinophilic pancreatitis (EP)” [1–7]. More recently, a microscopic examination of a pancreatic biopsy revealed that eosinophil infiltration occurs into the pancreatic duct, acini, and interstitium associated with fibrous connective tissue hyperplasia and accumulation of collagen [2].…”

Section: Introductionmentioning

confidence: 99%

Significance of Eosinophils in Promoting Pancreatic malignancy

Manohar

Verma

Venkateshaiah

et al. 2017

JGPLD

View full text Add to dashboard Cite

Background Several reports indicate that eosinophils are induced in chronic pancreatitis including patients with pancreatic malignancy. However, significance of eosinophilic pancreatitis (EP) is poorly understood and unexplored. Aim Accumulation and degranulation of eosinophils promote pancreatic fibrosis and malignancy. Method Human pancreatic tissue biopsy samples including chronic pancreatitis (n=3), malignant (n=4), non-malignant (n=3), and normal (n=3) were used for H&E, anti-MBP staining, anti-tryptase staining, anti-IgE staining and Mason’s trichrome staining. Results We show induced eosinophils and degranulated eosinophils indicated by the presence of anti-MBP stained extracellular granules in the malignant pancreatic (pancreatic cancer) and non-malignant human pancreatic tissues. A comparable number of eosinophils were observed in non-malignant and malignant pancreatic tissue sections, but the sections differed in degranulated eosinophils and the presence of extracellular granules. Additionally, induced mast cells and tissue-specific IgE positive cells were also detected in the tissue sections of malignant pancreatitis patients compared to non-malignant human pancreatic patients. Tissue-specific IgE induction is critical for the degranulation of eosinophils and mast cells that may lead to increased accumulation of collagen in malignant compared to non-malignant human pancreatic tissue samples. We show a large number of anti-tryptase stained extracellular granules in the tissue sections of malignant pancreatic cancer patients. Both IgE and eosinophil major basic proteins (MBP) are reported for the activation and degranulation of mast cells in tissues. Conclusion Taken together, our investigation concludes that eosinophils and mast cells accumulation and degranulation are critical in promoting pancreatitis pathogenesis that may lead to the development of pancreatic fibrosis and malignancy.

show abstract

Eosinophilic Pancreatitis Diagnosed With Endoscopic Ultrasound

Cited by 16 publications

References 12 publications

Eosinophilic pancreatitis versus pancreatitis associated with eosinophilic gastroenteritis – a systematic review regarding clinical features and diagnosis

Eosinophilic pancreatitis versus pancreatitis associated with eosinophilic gastroenteritis – a systematic review regarding clinical features and diagnosis

Immunological Responses Involved In Promoting Acute and Chronic Pancreatitis

Significance of Eosinophils in Promoting Pancreatic malignancy

Contact Info

Product

Resources

About