Clinical manifestations and functional outcomes in children with eosinophilic cystitis

• Published in: The Journal of urology Vol. 174; no. 6; p. 2347
• Main Authors: Thompson, R Houston, Dicks, Demetrius, Kramer, Stephen A
• Format: Journal Article
• Language: English
• Published: United States 01.12.2005
• Subjects: Adolescent; Child; Child, Preschool; Cystitis - diagnosis; Cystitis - physiopathology; Cystoscopy; Diagnosis, Differential; Eosinophilia - diagnosis; Eosinophilia - physiopathology; Female; Follow-Up Studies; Humans; Male; Medical Records; Retrospective Studies; Tomography, X-Ray Computed; Urinary Bladder Neoplasms - diagnosis; Urinary Bladder Neoplasms - physiopathology; Urinary Tract Infections - diagnosis; Urinary Tract Infections - physiopathology; Urination Disorders - diagnosis; Urination Disorders - physiopathology
• ISSN: 0022-5347
• DOI: 10.1097/01.ju.0000180423.06285.72

Eosinophilic cystitis is a rare disorder, with fewer than 30 pediatric cases reported in the literature. We describe our experience with pediatric eosinophilic cystitis during a 20-year period. Four children referred to our institution were subsequently diagnosed with eosinophilic cystitis between 1984 and 2004. A retrospective chart review was performed to assess clinical presentation, diagnosis, treatment and outcomes. Mean patient age at presentation was 10.8 years (range 5 to 18) and male-to-female ratio was 3:1. All 4 patients presented with irritative urinary symptoms, including 3 with dysuria and/or gross hematuria and 2 with urinary frequency, lower abdominal pain and/or a concomitant urinary tract infection. Allergic diseases (asthma, allergic rhinitis, etc) were present in 3 patients, and a formal allergen skin test was positive in 2 of those tested. A bladder mass mimicking malignancy was documented in 2 patients. Three patients had symptom resolution with conservative treatment, while 1 had development of an unremitting tumefactive process that eventually required partial cystectomy and bladder augmentation. Eosinophilic cystitis is a rare condition with a wide range of clinical manifestations. Children can present with a bladder mass mimicking sarcoma, underscoring the need for biopsy before diagnosis and treatment of a presumed oncological process. The condition usually follows a benign course, although unremitting progression remains a possibility.