Gut Liver.  2019 Mar;13(2):183-190. 10.5009/gnl18266.

What Are the Clinical Features and Etiology of Eosinophilic Liver Infiltration?

• Sim DW
• Son DJ
• Cho E
• Choi SK
• Shin SS
• Jun CH

• KMID: 2446803
• DOI: http://doi.org/10.5009/gnl18266

Abstract

BACKGROUND/AIMS
Although eosinophilic liver infiltration (ELI) is not rare, few data exist regarding its clinical characteristics and etiology. Therefore, we evaluated these aspects to better understand the clinical implications of this lesion type, which is reasonably common in Korea.
METHODS
Patients suspected of having ELI, based on abdominal computed tomography results obtained between January 2010 and September 2017, were enrolled in this retrospective study. The presumptive etiologies of ELI were categorized as parasite infections, hypereosinophilic syndrome (HES), eosinophilic granulomatosis with polyangiitis (EGPA), malignancies, and unidentified. Clinical courses and treatment responses were also evaluated.
RESULTS
The mean age of the enrolled patients (male, 237/328) was 62 years. Most patients (63%) were diagnosed incidentally and had peripheral eosinophilia (90%). Only 38% of the enrolled patients (n=126) underwent further evaluations to elucidate the etiology of the suspected ELI; 82 (25%) had parasite infections, 31 (9%) had HES, five (2%) had EGPA, and five (2%) had drug reactions in conjunction with eosinophilia and systemic symptoms. Almost half of the other enrolled patients had cancer. Radiologic resolution was achieved in 191 patients (61%; median time to radiologic resolution, 185 days). Resolution of peripheral eosinophilia was achieved in 220 patients (79%). In most cases, the course of ELI was benign.
CONCLUSIONS
This large ELI study is unique in that the incidence rate, underlying diseases, and clinical courses were comprehensively evaluated. Clinicians should investigate the etiology of ELI, as several of the underlying diseases require intervention rather than observation.

Keyword

Eosinophilic infiltration; Etiology; Hypereosinophilic syndrome; Liver; Parasite

MeSH Terms

Eosinophilia
Eosinophils*
Granulomatosis with Polyangiitis
Humans
Hypereosinophilic Syndrome
Incidence
Korea
Liver*
Parasites
Retrospective Studies