De Roza MA, Lim CH. Eosinophilic cholangitis treatment with budesonide. World J Hepatol 2017; 9(36): 1385-1388 [PMID: 29359024 DOI: 10.4254/wjh.v9.i36.1385]
Corresponding Author of This Article
Marianne Anastasia De Roza, MB.BS, MMED (Int Med), MRCP (UK), Registrar, Department of Gastroenterology and Hepatology, Singapore General Hospital, 20 College Road, Singapore 169856, Singapore. marianneanastasia.deroza@mohh.com.sg
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Dec 28, 2017; 9(36): 1385-1388 Published online Dec 28, 2017. doi: 10.4254/wjh.v9.i36.1385
Eosinophilic cholangitis treatment with budesonide
Marianne Anastasia De Roza, Chee Hooi Lim
Marianne Anastasia De Roza, Chee Hooi Lim, Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore 169856, Singapore
Author contributions: De Roza MA and Lim CH designed the report and analyzed the data; Lim CH reported and monitored outcomes; De Roza MA wrote the report; Both De Roza MA and Lim CH made critical revisions before final approval of the report.
Conflict-of-interest statement: There is no conflict of interest for all authors.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Marianne Anastasia De Roza, MB.BS, MMED (Int Med), MRCP (UK), Registrar, Department of Gastroenterology and Hepatology, Singapore General Hospital, 20 College Road, Singapore 169856, Singapore. marianneanastasia.deroza@mohh.com.sg
Telephone: +65-326-6693
Received: September 21, 2017 Peer-review started: September 22, 2017 First decision: October 17, 2017 Revised: October 21, 2017 Accepted: November 11, 2017 Article in press: November 12, 2017 Published online: December 28, 2017
ARTICLE HIGHLIGHTS
Case characteristics
Deranged liver function test with a cholestatic pattern, eosinophilia, raised IgE, intrahepatic biliary stricture.
Clinical diagnosis
Eosinophilic cholangitis.
Differential diagnosis
Biliary stone, pancreaticobiliary malignancy, drug induced liver injury.
Laboratory diagnosis
Eosinophilic cholangitis.
Imaging diagnosis
Biliary stricture and dilation.
Pathological diagnosis
Eosinophilic cholangitis.
Treatment
Budesonide 9 mg once a day.
Related reports
There are no previous reports of treating eosinophilic cholangitis with Budesonide. But there are reports of successful treatment with prednisolone. Please see reference No. 2.
Experiences and lessons
This is a rare case of eosinophilic cholangitis and the first time in literature, to be successfully treated with budesonide. The patient did not experience any side effects or steroid toxicity. In the future, with further evidence, budesonide might be a reasonable first line treatment for eosinophilic cholangitis as it is safer than prednisolone.
