Eosinophilic cholecystitis caused by Ascaris lumbricoides

Abstract

Eosinophilic cholecystitis is caused by the accumulation of eosinophils in the gallbladder wall and diagnosis is usually made based on histopathologic studies. The purpose of this paper is to comment on a case report published in World J Gastroenterol 2007 July; 13 (27): 3760-3762, about eosinophilic cholecystitis along with pericarditis without histopathological studies, which are considered necessary for its diagnosis.

Key Words: Eosinophilic cholecystitis, Ascaris lumbricoides, Pericarditis

TO THE EDITOR

Regarding the article eosinophilic cholecystitis along with pericarditis caused by Ascaris lumbricoides: A case report[1], a coproparasitoscopic test should have been conducted to demonstrate the presence of the parasite in the digestive tract of the patient, since the presence of the A. lumbricoides’s antigen in the blood is nonspecific and only refers to the contact of the patient with the parasite[2–4]. It is likely that the parasitosis is the cause both of the eosinophilia and the cholecystitis. Nevertheless, because the histopathological study to demonstrate an increase of eosinophils in the gallbladder wall was not conducted[1], the following doubt remains: did eosinophilia cause the cholecystitis? Because of clinical improvement with medical treatment with albendazole, surgery was not performed and the acute cholecystitis that went into remission following administration of the drug may be a consequence of migration of the parasite from the biliary tract[2].