Clinical features of clinically diagnosed eosinophilic liver abscesses

Abstract

Purpose: Eosinophilic liver abscesses (ELAs) are frequently encountered in the clinical field based on typical computed tomography (CT) findings and the presence of peripheral eosinophilia. In this study, the authors evaluated the clinical features and natural course of CT diagnosed ELAs.

Methods: The medical records of patients that underwent abdominal CT from July 2004 to February 2008 at Seoul National University Hospital were retrospectively evaluated. ELA was clinically diagnosed by the presence of peripheral eosinophilia (≥500 μL(-1)) and typical CT findings. The presumptive causes of clinically diagnosed ELA were divided into three categories, namely, parasitic infections, malignancies, and unidentified etiologies. Clinical courses and responses to treatment were evaluated.

Results: Clinically diagnosed ELAs were identified in 164 patients and the incidence of ELA was 0.68%. Of these patients, 118 (71.9%) showed radiologic resolution of clinically diagnosed ELA at a median 6.2 (0.2-33.1) months. In addition, 79 (48.2%) patients also achieved normalization of peripheral eosinophilia with radiologic resolution of clinically diagnosed ELA. In patients without identified etiologies, mean time to radiologic resolution was significantly shorter for patients treated empirically with an anti-parasitic drug than for those not treated [4.4 (0.9-26.3) vs. 12.2 (1.5-33.2) months, median (range), P = 0.001].

Conclusions: Clinically diagnosed ELA adopts a relatively benign course. Empirical anti-parasitic treatment in patients without an identified etiology may shorten the duration of clinically diagnosed ELA.

Keywords: Computed tomography; Eosinophilia; Eosinophilic granuloma; Eosinophilic infiltration; Liver diseases; Parasites; Toxocariasis; Visceral larva migrans.