title: Successful use of cyclosporine as treatment for eosinophilic cystitis: a case report.
abstract: BACKGROUND
  Eosinophilic cystitis is a rare inflammatory disorder characterized by eosinophilic infiltration of all layers of the urinary bladder wall. Due to lack of consensus and potential for side effect from various therapeutic options, treatment of the disease is often challenging.
  
  
  METHODS
  A 64-year old woman with hypertensive nephropathy resulting in stage III chronic kidney disease, obstructive sleep apnea, and obstructive lung disease presented with a 4 month history of dysuria, urgency, frequency, and persistent hematuria. Based on eosinophilic infiltration on bladder wall biopsy in the absence of any evidence of infection, malignancy, or immune disorder, she was diagnosed with eosinophilic cystitis. Despite multiple medication regimens, her symptoms persisted, requiring high-dose prednisone with steroid-related side effects. After four months, she was started on cyclosporine, which led to symptomatic improvement and reduction in prednisone dosage. At that time, repeat urine cytology and cystoscopy did not reveal friable tissues or eosinophiluria.
  
  
  CONCLUSIONS
  This case illustrates the utility of using cyclosporine to treat eosinophilic cystitis in adult patient with multiple comorbid conditions.
authors.affiliation: Division of Immunology, University at Iowa, 200 Hawkins Drive, Iowa City, IA 52242 USA ; Division of Immunology, Department of Internal Medicine - C42 GH, University of Iowa Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA 52242 USA.
authors.forename: Sohaib
authors.initials: S
authors.lastname: Aleem
authors.affiliation: Division of Immunology, University at Iowa, 200 Hawkins Drive, Iowa City, IA 52242 USA.
authors.forename: Bharat
authors.initials: B
authors.lastname: Kumar
authors.affiliation: Division of Immunology, University at Iowa, 200 Hawkins Drive, Iowa City, IA 52242 USA.
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Fasano
authors.affiliation: Department of Urology, University at Iowa, 200 Hawkins Drive, Iowa City, IA 52242 USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Takacs
authors.affiliation: Division of Immunology, University at Iowa, 200 Hawkins Drive, Iowa City, IA 52242 USA ; Present address: Division of Allergy and Clinical Immunology, John Hopkins Asthma & Allergy Center, 5501 Hopkins Bayview Circle, Baltimore, MD 21224 USA.
authors.forename: Antoine Emile
authors.initials: AE
authors.lastname: Azar
keywords: Cyclosporine; Eosinophilic cystitis; Steroids