PMC8235979_01
The laboratory data over the clinical course: eosinophils (eosino) and C-reactive protein (CRP). Methylprednisolone (mPSL, 1 g/day) was administered for 3 days. Prednisolone (PSL, 50 mg/day) was started on day 14 and tapered every week or fortnightly. Mepolizumab was administered on day 18.
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Laboratory testing of blood counts revealed marked eosinophilia (white blood cells (WBC): 14,300/microL and eosinophils: 8,000/microL), polyclonal hyperimmunoglobulinemia (IgG: 2,209 mg/dL, IgG4: 1,220 mg/dL, and IgE: 2,482 IU/dL), and an inflammatory response (C-reactive protein (CRP): 7.40 mg/dL) (Table 1 and Figure 1).
The histopathological examination of the gallbladder. It reveals a necrotic vasculitis and granulomatous inflammation with marked eosinophilic infiltration.
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The histopathological findings revealed necrotic vasculitis and granulomatous inflammation with marked eosinophilic infiltration (Figure 2).
The histopathological findings of the renal biopsy. Marked eosinophil infiltration is found in the interstitium, especially in the subcortex of the kidney, concomitant with tubular atropy. Nephrons are intact.
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On day 11, a kidney biopsy was performed, and the kidney tissue examination showed marked eosinophilic infiltration in the tubulointerstitial area and eosinophilic tubulitis, but glomerulonephritis was absent (Figure 3).