Eosinophilic pancreatitis: a rare or unexplored disease entity?
PDF (Русский)


pancreatitis, eosinophils, eosinophilic pancreatitis, pancreatic neoplasia, hypereosinophilic syndrome

How to Cite

Manohar, M., Verma, A. K., Singh, G., & Mishra, A. (2021). Eosinophilic pancreatitis: a rare or unexplored disease entity?. Herald of Pancreatic Club, 2(51), 20-25. Retrieved from https://vkp.org.ua/index.php/journal/article/view/234

Abstract views: 53
PDF Downloads: 14


Several case reports show accumulation of eosinophils in pancreatitis patients and term the disease as “eosinophilic pancreatitis” (EP). EP usually presents with a pancreatic tumour and abdominal pain in obstructive jaundice, which is generally not diagnosed until the patient undergoes pancreatic resection. Histologically, EP reveals distinct patterns like diffused, periductal, acinar, and septal inflammatory infiltrates with eosinophils, eosinophilic phlebitis, and localised extreme eosinophilic infiltrates related with pseudocyst formation. EP patients also have elevated serum IgE levels with high eosinophil counts in the pancreas as well as in other organs such as the gastrointestinal tract, which is termed as eosinophilic gastroenteritis. Due to the lack of knowledge based on just a few case reports, it is considered that eosinophilic infiltration is quite rare in the pancreas; therefore, the significance of eosinophils in pancreatitis is not yet established. This review assesses the current understanding of eosinophilic pancreatitis and the important role of eosinophils in promoting pancreatic fibrosis including malignancy.

PDF (Русский)


1. Abraham S.C., Leach S., Yeo C.J., et al. Eosinophilic pancreatitis and increased eosinophils in the pancreas. Am J SurgPathol. 2003. Vol. 27. P. 334–342.
2. Baek M.S., Mok Y.M., Han W.C., Kim Y.S. A patient with eosinophilic gastroenteritis presenting with acute pancreatitis and ascites. Gut Liver. 2014. Vol. 8. P. 224–227.
3. Barresi G., Inferrera C., De Luca F. Eosinophilic pancreatitis in the newborn infant of a diabetic mother. Virchows Arch A Pathol Anat Histol. 1978. Vol. 380. P. 341–348.
4. Barthet M., Hastier P., Buckley M.J., et al. Eosinophilic pancreatitis mimicking pancreatic neoplasia: EUS and ERCP findings: is nonsurgical diagnosis possible? Pancreas. 1998. Vol. 17. P. 419–422.
5. Bastid C., Sahel J., Choux R., et al. Eosinophilic pancreatitis: report of a case. Pancreas. 1990. Vol. 5. P. 104–107.
6. Bellaiche G., Fontaine H., Choudat L., et al. Pancreatic involvement, ascites and diarrhea in idiopathic hypereosinophilic syndrome. Gastroenterol Clin Biol. 1997. Vol. 21. P. 519–522.
7. Caglar E., Karismaz K., Dobrucali A. A case of eosinophilic gastroenteritis mimicking gastric lymphoma associated with pancreatitis due to duodenal involvement. Turk J Gastroenterol. 2012. Vol. 23. P. 585–589.
8. Cay A., Imamoglu M., Cobanoglu U. Eosinophilic pancreatitis mimicking pancreatic neoplasia. Can J Gastroenterol. 2006. Vol. 20. P. 361–364.
9. Descamps C., Billeret-Lebranchu V., Vankemmel M., et al. Eosinophilic pancreatitis: a difficult diagnosis. Gastroenterol Clin Biol. 1998. Vol. 22. P. 970–972.
10. Eugène C., Gury B., Bergue A., Quevauvilliers J. Icterus disclosing pancreatic involvement in idiopathic hypereosinophilic syndrome. Gastroenterol Clin Biol. 1984. Vol. 8. P. 966–999.
11. Euscher E., Vaswani K., Frankel W. Eosinophilic pancreatitis: a rare entity that can mimic a pancreatic neoplasm. Ann Diagn Pathol. 2000. Vol. 4. P. 379–385.
12. Flejou J.F., Potet F., Bernades P. Eosinophilic pancreatitis: a rare manifestation of digestive allergy? Gastroenterol Clin Biol. 1989. Vol. 13. P. 731–733.
13. Fujimoto T., Imaeda H., Takahashi K., et al. Eotaxin-3 (CCL26) expression in human pancreatic myofibroblasts. Pancreas. 2016. Vol. 45. P. 420–424.
14. George E.R., Patel S.S., Sen P., Sule N. A unique case of eosinophilic pancreatitis and anencephaly in the fetus of a type i diabetic mother. Gastroenterology Res. 2011. Vol. 4. P. 174–176.
15. Hayden D.W., Kruiningen H.J. Experimentally induced canine toxocariasis: laboratory examinations and pathologic changes, with emphasis on the gastrointestinal tract. Am J Vet Res. 1975. Vol. 36. P. 1605–1614.
16. Hirata J., Koga T., Nishimura J., Ibayashi H. Pancreatic carcinoma associated with marked eosinophilia: a case report. Eur J Haematol. 1987. Vol. 39. P. 462–466.
17. Imbert Y., Strainchamps P., Ducos P., et al. Acute outbreaks of chronic pancreatitis associated with recurrent hypereosinophilia in patients with progressive lipodystrophy. Presse Med. 1984. Vol. 13. P. 1850.
18. Javid Bhat K., Bhat S., Dutt K., et al. Chronic diarrhea, eosinophilic ascites, acute pancreatitis and deep venous thrombosis: a case report. Caspian J Intern Med. 2014. Vol. 5. P. 182–185.
19. Juniper K. Jr. Chronic relapsing pancreatitis with associated marked eosinophilia and pleural effusion. Am J Med. 1955. Vol. 19. P. 648–651.
20. Kakodkar S., Omar H., Cabrera J., Chi K. Eosinophilic pancreatitis diagnosed with endoscopic ultrasound. ACG Case Rep J. 2015. Vol. 2. P. 239–241.
21. Kamisawa T., Anjiki H., Egawa N., Kubota N. Allergic manifestations in autoimmune pancreatitis. Eur J Gastroenterol Hepatol. 2009. Vol. 21. P. 1136–1139.
22. Le Connie D., Nguyen H. Eosinophilic gastroenteritis, ascites, and pancreatitis: a case report and review of the literature. South Med J. 2004. Vol. 97. P. 905–906.
23. Lyngbaek S., Adamsen S., Aru A., Bergenfeldt M. Recurrent acute pancreatitis due to eosinophilic gastroenteritis. Case report and literature review. JOP. 2006. Vol. 7. P. 211–217.
24. Maeshima A., Murakami H., Sadakata H., et al. Eosinophilic gastroenteritis presenting with acute pancreatitis. J Med. 1997. Vol. 28. P. 265–272.
25. Manohar M. Eosinophilic pancreatitis need an attention. J Pulmonol Clin Res. 2017. Vol. 1. P. 1–2.
26. Manohar M., Verma A.K., Venkateshaiah S.U., et al. Chronic pancreatitis associated acute respiratory failure. MOJ Immunol. 2017. Vol. 5. P. 00149.
27. Manohar M., Verma A.K., Venkateshaiah S.U., et al. Pathogenic mechanisms of pancreatitis. World J Gastrointest Pharmacol Ther. 2017. Vol. 8. P. 10–25.
28. Manohar M., Verma A.K., Venkateshaiah S.U., Mishra A. Food-induced acute pancreatitis. Dig Dis Sci. 2017. Vol. 62. P. 3287–3297.
29. Manohar M., Verma A.K., Venkateshaiah S.U., Mishra A. Immunological responses involved in promoting acute and chronic pancreatitis. J Clin Immunol Res. 2017. Vol. 1. P. 1–8.
30. Manohar M., Verma A.K., Venkateshaiah S.U., Mishra A. Role of eosinophils in the initiation and progression of pancreatitis pathogenesis. Am J Physiol Gastrointest Liver Physiol. 2018. Vol. 314. P. G211–222.
31. Manohar M., Verma A.K., Venkateshaiah S.U., Mishra A. Significance of eosinophils in pathogenesis of pancreatitis associated malignancy. J Gastroenterol Pancreatol Liver Disord. 2017. Vol. 4. P. 1–9.
32. Novaes G., Cardozo de C., Costa N.M., et al. Experimental chronic interstitial pancreatitis induced by scorpion toxin in rats. Arq Gastroenterol. 1990. Vol. 27. P. 187–190.
33. Payan H., Lebreuil G., Vague P. Eosinophilic cell pancreatitis in newborn infants of diabetic mothers. Ann Anat Pathol. 1968. Vol. 13. P. 87–96.
34. Petty D.P., Lange A.L., Verster A., Hattingh J. Necropsies of eight horses infected with Strongylusequinus and Strongylus edentates. J S Afr Vet Assoc. 1992. Vol. 63. P. 66–69.
35. Polyak S., Smith T.A., Mertz H. Eosinophilic gastroenteritis causing pancreatitis and pancreaticobiliary ductal dilation. Dig Dis Sci. 2002. Vol. 47. P. 1091–1095.
36. Rakesh K., Banerjee R., Gupta R., et al. Eosinophilic pancreatitis with pseudocyst. Indian J Gastroenterol. 2007. Vol. 26. P. 136–137.
37. Reppucci J., Chang M., Hughes S., Liu X. Eosinophilic pancreatitis: a rare cause of recurrent acute pancreatitis. Case Rep Gastroenterol. 2017. Vol. 11. P. 120–126.
38. Robbie M.J., Scurry J.P., Stevenson P. Carbamazepine-induced severe systemic hypersensitivity reaction with eosinophilia. Drug Intell Clin Pharm. 1988. Vol. 22. P. 783–784.
39. Sah R.P., Pannala R., Zhang L., et al. Eosinophilia and allergic disorders in autoimmune pancreatitis. Am J Gastroenterol. 2010. Vol. 105. P. 2485–2491.
40. Straumann A., Safroneeva E. Eosinophils in the gastrointestinal tract: friends or foes? Acta Gastroenterol Belg. 2012. Vol. 75. P. 310–315.
41. Suzuki S., Homma T., Kurokawa M., et al. Eosinophilic gastroenteritis due to cow’s milk allergy presenting with acute pancreatitis. Int Arch Allergy Immunol. 2012. Vol. 158, Suppl. 1. P. 75–82.
42. Tian L., Fu P., Dong X., et al. Eosinophilic pancreatitis: three case reports and literature review. Mol Clin Oncol. 2016. Vol. 4. P. 559–562.
43. Tokoo M., Oguchi H., Kawa S., et al. Eosinophilia associated with chronic pancreatitis: an analysis of 122 patients with definite chronic pancreatitis. Am J Gastroenterol. 1992. Vol. 87. P. 455–460.
44. Tse K.Y., Christiansen S.C. Eosinophilic gastroenteritis due to egg allergy presenting as acute pancreatitis. Allergy Rhinol. 2015. Vol. 6. P. 80–81.
45. Vazquez Rodriguez J.J., Soleto Saez E., Sanchez Vega J., et al. Pancreatitis and eosinophilic gastroenteritis. Int Surg. 1973. Vol. 58. P. 415–419.
46. Wang Q., Lu C.M., Guo T., Qian J.M. Eosinophilia associated with chronic pancreatitis. Pancreas. 2009. Vol. 38. P. 149–153.
47. Zheng L., Xue J., Jaffee E.M., Habtezion A. Role of immune cells and immune-based therapies in pancreatitis and pancreatic ductal adenocarcinoma. Gastroenterology. 2013. Vol. 144. P. 1230–1240.