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Case Reports
. 2022 Nov 15;6(1):8-12.
doi: 10.1002/iju5.12533. eCollection 2023 Jan.

A conservative treatment for eosinophilic cystitis

Franco Alchiede Simonato  1 , Nicola Pavan  2 , Mirko Pinelli  2 , Gabriele Tulone  2 , Rosa Giaimo  2 , Anna Martorana  3 , Alchiede Simonato  2
Affiliations
Case Reports

A conservative treatment for eosinophilic cystitis

Franco Alchiede Simonato et al. IJU Case Rep. .

Abstract

Introduction: Eosinophilic cystitis is a rare condition which causes common symptoms and may mimic other conditions. Eosinophilic cystitis has several causes such as hypereosinophilic syndrome, inflammatory diseases, neoplasia, parasites or fungal infection, IgE-related diseases, Drug Reaction and Eosinophilia and Systemic Symptoms (DRESS) syndrome, or Churg-Strauss syndrome. Therefore, differential diagnosis is difficult.

Case presentation: We report the case of a middle-aged man affected by eosinophilic cystitis with persistent hematuria and other peculiar symptoms that may be brought back to hypereosinophilic crisis.

Conclusion: Conservative approach is preferred, avoiding radical cystectomy rather than corticosteroid, antihistaminic and second line therapy. Hyperbaric therapy is an innovative approach for severe relapsing gross hematuria without specific literature and should be studied for further indications.

Keywords: conservative therapy; eosinophilic cystitis; hematuria; hyperbaric therapy; hypereosinophilic syndrome.

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Conflict of interest statement

The authors declare no conflicts of interest associated with this manuscript.

Figures

Fig. 1
Fig. 1
Cystoscopic images taken during a biopsy for diagnostic assessment: (a) Ulcerated pseudopolypoid lesion on the bottom of the bladder; (b) endoscopic biopsy of the postero‐lateral wall of the urinary bladder; (c) resection bed: normal tissue layers are not visible.
Fig. 2
Fig. 2
Biopsy of the posterior wall of the urinary bladder, compatible with the diagnosis of HE. (a) Severe inflammation extended to the muscular layer; (b) occasional multinucleated giant cells and foci of necrosis (hematoxylin–eosin ×100); (c) eosinophilic infiltrate (Hematoxylin–eosin ×400); (d) numerous eosinophils in chorion (Giemsa ×400).
Fig. 3
Fig. 3
(a) Uro‐CT showing hypervascularization around the bladder, thickening of posterolateral wall, an effusion due to vesical rupture in the anterolateral wall and enlargement of locoregional lymph nodes; (b) chart diagram with time showing the clinical course with symptoms, exams, and therapies.
See this image and copyright information in PMC

References

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