Clinical manifestations and functional outcomes in children with eosinophilic cystitis.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Thompson
R Houston
RH
Department of Urology, Mayo Medical School and Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Dicks
Demetrius
D
Kramer
Stephen A
SA
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003556:Cystitis / Q000175:diagnosis* / Q000503:physiopathology*; D003558:Cystoscopy; D003937:Diagnosis, Differential; D004802:Eosinophilia / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008499:Medical Records; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000503:physiopathology; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000503:physiopathology; D014555:Urination Disorders / Q000175:diagnosis / Q000503:physiopathology