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Eosinophilic cystitis


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Overview

What is eosinophilic cystitis?

What are the signs and symptoms of eosinophilic cystitis?

What causes eosinophilic cystitis?

How might eosinophilic cystitis be treated?

What is the prognosis of eosinophilic cystitis?

What is eosinophilic cystitis?

Eosinophilic cystitis (EC) is a rare inflammatory bladder condition caused by the build up of eosinophils in the bladder. The exact cause of this condition is not known. However, EC has been found in those with allergies and asthma, and in those with a history of bladder trauma or infection, open bladder surgery, or surgery for a bladder tumor. EC has also been found in those who take certain medications.[1][2]
Last updated: 8/20/2014

What are the signs and symptoms of eosinophilic cystitis?

Common symptoms include urinary frequency, painful urination, blood in the urine, and abdominal/pelvic pain. Other less common symptoms include excessive urination during the night and urinary retention. Many of the symptoms commonly seen in EC mimic symptoms seen in other conditions. Rare features include gastrointestinal symptoms because of eosinophilic gastroenteritis, skin rash, and the passage of air in the urine (pneumaturia). EC has been observed in 2% of patients with superficial transitional cell carcinoma (bladder cancer).[1]
Last updated: 6/2/2011

What causes eosinophilic cystitis?

The cause of eosinophilic cystitis remains unclear, although it has been associated with allergies, reactions to certain medications (antibiotics, chemotherapy), bladder trauma, bladder tumors, and parasitic infections.[1][2]
Last updated: 8/20/2014

How might eosinophilic cystitis be treated?

Any possible causative factors, should be avoided or discontinued, such as certain medications (tranilast, mitomycin C). Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, and antihistamines have been used as the primary management of choice with good results. Antibiotics are helpful, especially in those individuals with EC associated with urinary tract infections. Those who do not respond to NSAIDs and antihistamines have been treated with corticosteroids. Corticosteroids and antihistamines are used because they suppress the inflammatory reaction in the bladder.[3] However, symptoms of EC may persist, despite steroid therapy. If symptoms persist after steroid therapy, azathioprine or cyclosporine can be tried.[3] Other treatments include intravesical dimethylsulfoxide, cyclosporin-A (immunosuppressant drug), and silver nitrate.[1]

In those with bladder lesions, surgery has been successful. Few patients with progressive EC not responding to medical therapy or surgery may be considered for more radical procedures, such as partial/total cystectomy (surgical removal of all or part of the bladder).[1]
Last updated: 10/31/2014

What is the prognosis of eosinophilic cystitis?

Most patients can be cured, but recurrence is a frequent finding. One study examined 118 patients who were treated for eosinophilic cystitis. Of these, 91 patients (77%) were cured, which was defined as the complete absence of symptoms in the short-term and long-term. However, the recurrence of symptoms has been noted in some affected individuals.[3] Thus, those with EC require long-term follow-up with relevant blood tests, urine examination, appropriate imaging, and cystoscopy.[1]
Last updated: 6/2/2011

References
  1. Teegavarapu PS, Sahai A, Chandra A, Dasgupta P, Khan MS. Eosinophilic cystitis and its management. Int J Clin Pract. 2005; 59(3):356-60. http://www.ncbi.nlm.nih.gov/pubmed/15857336. Accessed 10/31/2014.
  2. Eosinophilic Cystitis. American Partnership for Eosinophilic Disorders. September 8, 2011; http://apfed.org/drupal/drupal/eosinophilic_cystitis. Accessed 8/20/2014.
  3. van den Ouden D. Diagnosis and management of eosinophilic cystitis: a pooled analysis of 135 cases. Eur Urol. 2000; 37(4):386-94. http://www.ncbi.nlm.nih.gov/pubmed/10765067. Accessed 10/31/2014.


See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.