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Zhang X, Zhang G, Zhang L, Sun C, Liu N, Chen M. Spontaneous rupture of the urinary bladder caused by eosinophilic cystitis in a male after binge drinking: A case report. Medicine (Baltimore) 2017; 96:e9170. [PMID: 29390453 PMCID: PMC5758155 DOI: 10.1097/md.0000000000009170] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Spontaneous rupture of the urinary bladder is a rare, difficult to diagnose surgical emergency with a high mortality, there are many causes for spontaneous rupture of the urinary bladder, but we only found 2 reports on this condition in our literature search. A 36-year-old male patient was admitted with "whole abdominal pain associated with hematuria for 5 hours." Our patient did not have a history of definite allergy, but a long-term history of alcohol abuse. This patient was followed up for 1 year, and the cystoscopy recheck showed that the bladder lesion had healed. CONCLUSIONS Since eosinophilic cystitis is associated with long-term alcohol consumption, we recommended that the patient should stop drinking and taking antihistamines.
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Affiliation(s)
| | - Guangyuan Zhang
- School of Medicine, Southeast University
- Department of Urology Surgery, Zhongda Hospital, Southeast University, Nanjing, China
| | - Lei Zhang
- School of Medicine, Southeast University
- Department of Urology Surgery, Zhongda Hospital, Southeast University, Nanjing, China
| | - Chao Sun
- School of Medicine, Southeast University
- Department of Urology Surgery, Zhongda Hospital, Southeast University, Nanjing, China
| | - Ning Liu
- School of Medicine, Southeast University
- Department of Urology Surgery, Zhongda Hospital, Southeast University, Nanjing, China
| | - Ming Chen
- School of Medicine, Southeast University
- Department of Urology Surgery, Zhongda Hospital, Southeast University, Nanjing, China
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Mosholt KSS, Dahl C, Azawi NH. Eosinophilic cystitis: three cases, and a review over 10 years. BMJ Case Rep 2014; 2014:bcr-2014-205708. [PMID: 25312971 DOI: 10.1136/bcr-2014-205708] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Eosinophilic cystitis (EC) is a rare disease. We describe three cases, where presentations of the disease are similar. To highlight probable causes of the disease, symptoms, clinical findings and treatment modalities, we reviewed 56 cases over a 10-year period. The most common symptoms were frequency, dysuria, urgency, pain and haematuria. Common clinical findings were presence of bladder mass, peripheral eosinophilia and thickened bladder wall. A variety of medical treatments were used, most frequently steroids, antibiotics and antihistamines. Recurrence occurred in patients on tapering or discontinuing prednisone, among other reasons. There is no consensus about the treatment of EC, but In light of our findings in this review, the treatment of choice in our department will be tapered prednisone over 6-8 weeks in combination with antihistamine.
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Affiliation(s)
| | - Claus Dahl
- Urological Department, Roskilde Hospital, Roskilde, Denmark
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Zhao L, Hart J. Histologic mimics of inflammatory bowel disease. Semin Diagn Pathol 2014; 31:137-51. [PMID: 24815939 DOI: 10.1053/j.semdp.2014.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This review summarizes a variety of clinical and histologic mimics of idiopathic inflammatory bowel disease. All the entities that are included demonstrate one or more histologic features typical of idiopathic inflammatory bowel disease that may lead to potential diagnostic confusion and misinterpretation by the pathologist. The elements of the clinical history, laboratory test results, and endoscopic findings that are helpful to the surgical pathologist in considering a diagnosis other than idiopathic inflammatory bowel disease are emphasized. On occasion, a poor response to standard treatment for idiopathic inflammatory bowel disease is the clue that prompts reconsideration of the initial diagnosis. Subtle histologic features, special stains, or other diagnostic methodologies that can aid in proper diagnosis are also discussed.
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Affiliation(s)
- Lei Zhao
- Department of Pathology, University of Chicago Medical Center, 5840 S. Maryland Ave., MC6101 Chicago, Illinois 60637
| | - John Hart
- Department of Pathology, University of Chicago Medical Center, 5840 S. Maryland Ave., MC6101 Chicago, Illinois 60637.
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Jiang P, Wang C, Jin B, Lin Y, Chen S. Eosinophilic cystitis in a patient with hypereosinophila syndrome: A case report. Exp Ther Med 2014; 8:49-51. [PMID: 24944595 PMCID: PMC4061232 DOI: 10.3892/etm.2014.1706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 04/29/2014] [Indexed: 11/06/2022] Open
Abstract
Hypereosinophilic syndrome (HES) is a rare disorder that is characterized by hypereosinophilia and organ damage, caused by the infiltration of eosinophils. In rare cases, the urinary bladder may also be involved. The current case report presented a 56-year-old male with gross hematuria and hypereosinophilia. The diagnosis of eosinophilic cystitis associated HES was established. Oral prednisone with a slow tapering regimen was administered as the primary treatment for the patient, which achieved partial hematological remission and complete relief of cystitis during a six-month follow-up period. Although eosinophilic cystitis is not commonly the primary manifestation of HES, eosinophilic cystitis should be taken into consideration following the onset of urinary symptoms in patients with HES.
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Affiliation(s)
- Peng Jiang
- Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Chaojun Wang
- Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Baiye Jin
- Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Yiwei Lin
- Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Shanwen Chen
- Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
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Bates AWH. Diagnosing eosinophilic colitis: histopathological pattern or nosological entity? SCIENTIFICA 2013; 2012:682576. [PMID: 24278727 PMCID: PMC3820477 DOI: 10.6064/2012/682576] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 05/06/2012] [Indexed: 06/02/2023]
Abstract
Reports of "eosinophilic colitis"-raised colonic mucosal eosinophil density in patients with lower gastrointestinal symptoms-have increased markedly over the last fifteen years, though it remains a rarity. There is no consensus over its diagnosis and management, and uncertainty is compounded by the use of the same term to describe an idiopathic increase in colonic eosinophils and an eosinophilic inflammatory reaction to known aetiological agents such as parasites or drugs. In patients with histologically proven colonic eosinophilia, it is important to seek out underlying causes and careful clinicopathological correlation is advised. Because of the variability of eosinophil density in the normal colon, it is recommended that histological reports of colonic eosinophilia include a quantitative morphometric assessment of eosinophil density, preferably across several sites. Few reported cases of "eosinophilic colitis" meet these criteria. As no correlation has been shown between colonic eosinophil density and symptoms in older children or adults, it is suggested that treatment should be directed towards alleviation of symptoms and response to treatment assessed clinically rather than by histological estimates of intramucosal eosinophils.
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Affiliation(s)
- Alan W. H. Bates
- Research Department of Pathology, University College London, London WC1E 6BT, UK
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Kojima K, Maeda J, Mikami S, Yamagishi H, Ide H, Hattori S, Takahashi T, Awazu M. Eosinophilic cystitis presented as a manifestation of hypereosinophilic syndrome: a case report and review of the literature. NEPHRON EXTRA 2013; 3:30-5. [PMID: 23573073 PMCID: PMC3618051 DOI: 10.1159/000346713] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND 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. METHODS We performed a literature search in PubMed from 2001 to 2012 to find patients with EC who may have had HES. RESULTS 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. CONCLUSION HES may not be uncommon as the cause of EC. Thorough evaluation and close monitoring are warranted in EC patients with elevated eosinophils.
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Affiliation(s)
- Katsuaki Kojima
- Department of Pediatrics, School of Medicine, Keio University, Tokyo, Japan
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Butterfield JH. Treatment of hypereosinophilic syndromes with prednisone, hydroxyurea, and interferon. Immunol Allergy Clin North Am 2007; 27:493-518. [PMID: 17868861 DOI: 10.1016/j.iac.2007.06.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The hypereosinophilic syndromes continue to challenge our clinical acumen and skills. Prednisone, hydroxyurea, and interferon alpha 2b are three of the oldest agents that allow control of eosinophilia and its devastating clinical consequences. They still work. As our experience with them has grown, it has become evident that use of these agents in combination will control eosinophilia in most patients. Moreover, with time, the doses can frequently be reduced. Even with the advent of newer agents for treatment of hypereosinophilic syndromes, these three medications still afford an excellent, cost-effective avenue for disease management.
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Affiliation(s)
- Joseph H Butterfield
- Division of Allergic Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA.
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Abstract
Although we know that eosinophils reside in the normal gastrointestinal tract and increase during inflammatory states, their exact role in gut homeostasis and in the pathogenesis of inflammatory processes is not certain. An increasing number of clinical reports suggest that eosinophils participate in the pathogenesis of mucosal inflammation, and emerging literature is beginning to define these mechanisms. For example, homing of eosinophils to the gastrointestinal tract is better understood with respect to the roles of specific eosinophilic attractants, such as the eotaxins and interleukin-5. As mechanisms of eosinophil recruitment, activation, and functional responses are further elucidated, novel targets for treatment strategies in specific diseases will likely follow. We review recent developments in eosinophil immunobiology as they relate to gastrointestinal inflammation and provide an update on clinical aspects of eosinophilic esophagitis as they relate to eosoinophilic diseases of the gastrointestinal tract.
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Affiliation(s)
- Esi S N Lamousé-Smith
- Children's Hospital Boston, 300 Longwood Avenue, Hunnewell Ground Floor, Boston, MA 02115, USA
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