• Cengiz Karacaer, Ahmet Tarik Eminler, Bilal Toka, Mukaddes Tozlu, Erkan Parlak, and Aydin Seref Koksal.
• Department of Internal Medicine, Sakarya University Research and Education Hospital, Sakarya, Turkey.
• J Coll Physicians Surg Pak. 2020 Nov 1; 30 (11): 1143-1148.

ObjectiveTo compare recovery of eosinopenia, C-reactive protein (CRP) and procalcitonin levels in predicting the response to treatment in patients with cholangitis.Study DesignDescriptive, analytical study.Place And Duration Of StudyDepartment of Gastroenterology, Sakarya Training and Research Hospital, Turkey between September 2018 and February 2019.Methodology Patients with cholangitis, who underwent endoscopic retrograde cholangiopancreatography (ERCP), were inducted. Those with choledocholic thiasis alone were considered controls. Eosinophil count above 100.5 cells/µL was the limit value accepted as improvement. ERCP repeat was decided according to eosinophil count below 100.5 and not clinically improving. Relationship between inflammatory markers such as CRP, procalcitonin and eosinopenia values in patients with stone-associated cholangitis was investigated.ResultsThe cholangitis group was comprised of 62 patients [mean age 67±14.57 years; 26 (41.9%) female], while control group was comprised  of 57 patients [mean age 57.4±18.10 years; 39 (68.4%) females, p=0.004]. At time of admission, median eosinophils was significantly lower in cholangitis group at 17.50 [9.82-84] ×103/µL compared to control group at 168 [100.11-270] ×103/µL (p=0.001). ERCP were repeated on two patients as their clinical conditions and unremitting eosinophil counts worsened. Eosinophil and CRP markers and clinical improvement were observed after  second ERCP procedure.ConclusionEosinopenia may be used as inflammatory marker in  evaluation of response to treatment and for predicting the need to repeat ERCP during clinical follow-up of patients who undergo cholangitis treatment. Key Words: Cholangitis, C-reactive protein, Endoscopic retrograde cholangiopancreatography, Eosinopenia, Procalcitonin.

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