Eosinophilic cystitis is a rare form of noninfectious cystitis and is of an uncertain cause.


Clinical findings suggesting cystitis:

(1) dysuria

(2) hematuria, which may be gross

(3) urinary frequency or retention

(4) lower abdominal pain

(5) occasionally a palpable suprapubic mass

(6) occasionally nocturia


Concurrent findings may include:

(1) eosinophilia in the peripheral blood

(2) history of allergy

(3) asthma

(4) eosinophilic infiltrates in GI tract

(5) eosinophiluria

(6) allergic skin rash


Imaging findings:

(1) thickened, irregular bladder wall

(2) mass lesion

(3) vesicoureteral reflux


Findings on cystoscopy:

(1) normal mucosa (diagnosis may be missed if biopsies are not taken)

(2) mucosal edema and erythema

(3) plaque-like lesions

(4) necrotic ulcerations


Pathologic findings on bladder wall biopsy:

(1) eosinophilic infiltrate in the lamina propria and muscularis propria


A few patients may have progressive disease with diffuse bladder fibrosis and an obstructive uropathy.


Differential diagnosis:

(1) bacterial cystitis (which may be present concurrently)

(2) interstitial cystitis

(3) malacoplakia

(4) bladder tumor


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