Recurrent Eosinophilic Pancreatitis With Eosinophilic Gastroenteritis: A Case Report

Area of Science:

• Gastroenterology
• Pathology
• Endocrinology

Background:

• Eosinophilic pancreatitis (EP) is rare (<1% of cases) and difficult to diagnose due to overlapping symptoms with other pancreatitis types.
• Diagnostic challenges stem from heterogeneous presentations and the need for invasive biopsy to confirm eosinophilic infiltration.
• High misdiagnosis rates occur due to rarity and invasiveness of pancreatic biopsy.

Purpose of the Study:

• To present a case report detailing imaging and histopathology findings of eosinophilic pancreatitis.
• To highlight the diagnostic challenges and effective treatment strategies for EP.
• To emphasize the association between EP and subclinical eosinophilic gastroenteritis (EGE).

Main Methods:

• Case report of a 68-year-old man with recurrent pancreatitis.
• Diagnostic tools included CT, MRCP, EUS, and EUS-guided fine-needle aspiration (EUS-FNA).
• Diagnosis confirmed by histological evidence of eosinophilic infiltration (>10/hpf) after excluding secondary causes.

Main Results:

• The patient presented with recurrent severe abdominal pain and was diagnosed with EP.
• Eosinophilic gastroenteritis (EGE) was incidentally found during initial endoscopy.
• EUS-FNA confirmed EP; symptoms resolved rapidly with corticosteroid therapy.

Conclusions:

• Eosinophilic pancreatitis is a rare but severe pancreatitis subtype requiring early diagnosis.
• Endoscopy can aid in definitive histological diagnosis for unexplained pancreatitis.
• Corticosteroid therapy is highly effective in managing EP and associated EGE, resolving symptoms and preventing progression.