Cystitis eosinophilc N30.8

Rare, chronic, esosinophilic, transmural inflammation of the bladder wall, which can occur independently, but also as a partial symptom of idiopathic hypereosinophilic syndrome (HES).

A distinction is made between allergic and non-allergic eosinophilic cystitis.

Allergic reactions to inhalative allergens (simultaneous occurrence with bronchial asthma or other allergic organ diseases) Food allergens, drugs, foreign bodies and parasites are discussed.

In the case of non-allergic eosinophilic cystitis, the history often shows transurethral resections with and without topical chemotherapy.

Possible at any age. About 1/3 of the cases refer to children.

Hematuria, dysuria and suprapubic pain. Patients may become clinically conspicuous due to the development of a tumorous neoplasm (possibly incidental sonographic detection).

Mostly clear blood eosinophilia

Beneath a hyperplastic urothelium, diffuse eosinophilic infiltrates of varying density are found in the edematous lamina propria, which also infiltrate the urothelium in places. Also giant foreign body cells.

Cystoscopy with bioptic backup. In rare cases, granulomatous or glandular pseudotumours may occur. In this case, bioptic malignancy must be ruled out.

Since there are no standardized treatment methods due to the rarity of the disease pattern, oncological control and individual therapy should be closely monitored and carried out. Anthistamines were mostly used in combination with corticosteroids.

Follow-up examinations are particularly indicated in cases of a significant proliferation tendency of the urothelium, but the development of a malignoma has not been described so far.

1. Saadi A et al (2015) Pseudotumoral eosinophilic cystitis. Urol Case Rep 3:65-67.
2. Mosholt KS et al (2014) Eosinophilic cystitis: three cases, and a review over 10 years. BMJ Case Rep pii: bcr2014205708.
3. Kojima K et al (2013) Eosinophilic cystitis presented as a manifestation of hypereosinophilic syndrome: a case report and review of the literature. Nephron Extra 3:30-35.
4. Nofal R (2007) Eosinophilic cystitis as a symptom of idiopathic hypereosinophilic syndrome. Act urol 38: 148-151
5. Sparks S et al (2013) Eosinophilic cystitis in the pediatric population: a case series and review of the literature. J Pediatric Urol 9:738-744.