Eosinophilic cystitis

Department of Urology, University Hospital Dijkzigt, PO Box 2040, 3000 CA Rotterdam, Netherlands.
Archives of Disease in Childhood (Impact Factor: 2.9). 05/2001; 84(4):344-6.
Source: PubMed


We describe four cases of eosinophilic cystitis in whom no specific cause could be found, and review the literature. Complaints at presentation included urgency, frequency, abdominal pain, and haematuria. In three patients the symptoms and ultrasound pictures suggested a bladder tumour. One patient was treated with anticholinergics and corticosteroids without relief of symptoms; a localised eosinophilic tumour was excised in one patient who remained symptom free; and two patients were managed conservatively with spontaneous resolution of bladder pathology and symptoms. One case was identified by random bladder biopsy in 150 consecutive patients with unexplained irritable micturition complaints. Eosinophilic cystitis is rare in children. After biopsy, we consider a wait and see policy is justified as symptoms tend to disappear spontaneously. Routine bladder biopsies in children with unexplained bladder symptoms is not justifiable.

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Available from: Peter G J Nikkels
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    • "We found 4 patients who had HES and EC including the present patient and 14 EC patients who had no etiology and an eosinophil count as described in the report [3,4,5,6,7,8,9,10,11,12,13,14,15]. Of the 14 patients reported as EC, 5 had an eosinophil count of ≥1,500/μl on at least one occasion without apparent cause of eosinophilia, which suggests that these patients had HES (table 1). "
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    ABSTRACT: Hypereosinophilic syndrome (HES) is a group of disorders marked by the sustained overproduction of eosinophils, in which eosinophilic infiltration and inflammatory substance release cause damage to multiple organs. Eosinophilic cystitis (EC) is an inflammatory disorder caused by eosinophilic infiltration of the bladder wall. Although EC is often associated with eosinophilia, it has been rarely reported as a manifestation of HES. We report a case of EC as a primary manifestation of HES. The patient was a 27-year-old male with a history of complete intracardiac repair of tetralogy of Fallot who presented with an acute onset of dysuria accompanied by eosinophilia (7.5 × 10(3)/μl, 60% of white blood cells). Ultrasonography and MRI of the bladder showed a bladder mass, a biopsy of which revealed eosinophilic infiltration and degranulation. We performed a literature search in PubMed from 2001 to 2012 to find patients with EC who may have had HES. There were 4 patients with HES who had EC including the present case. Of 14 patients reported as EC in whom the eosinophil count was described, 5 had eosinophils of ≥1,500/μl. None of the 5 patients had secondary causes for eosinophilia. Of the 9 patients with definite or probable HES, 7 patients (78%) were male and 5 patients (56%) showed a concomitant eosinophilic gastrointestinal disorder. HES may not be uncommon as the cause of EC. Thorough evaluation and close monitoring are warranted in EC patients with elevated eosinophils.
    Full-text · Article · Feb 2013
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    • "The condition is often confused with tumors of the bladder [5], urinary tract infections or parasitosis. Verhagen et al. reported from their literature survey that only 5 of 24 pediatric patients had allergies, and of their own 4 patients 2 were known to have allergies [2]. Although many diagnostic investigations have been performed, the importance of the allergenic factor is usually not clear. "
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    ABSTRACT: Eosinophilic cystitis is an inflammatory condition characterized by eosinophilic infiltration of whole layers of the bladder wall. The condition occurs more commonly in adults. We report a case of eosinophilic cystitis mimicking a bladder tumor in a 5-year-old boy with symptoms of dysuria and urinary incontinence. The diagnosis was confirmed by histopathology and he underwent clinical treatment with trimethoprim-sulfamethoxazole and antihistamine (cetirizine). The symptoms fully resolved in follow up, which is continuing. Although very rare, eosinophilic cystitis should be considered in cases of dysuria and increased bladder wall thickness but no identified urinary tract infection.
    Full-text · Article · May 2012 · Journal of pediatric urology
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