Eosinophilic cystitis: three cases, and a review over 10 years

Abstract

SUMMARYEosinophilic 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.

Eosinophilic cystitis with recurrent urinary retention: case report

“…In the previous studies, the most obvious cause for recurrence was insufficient dose of steroids (early tapering) 3. In light of this, we maintained and increased the prednisone dose.…”

“…Mosholt et al performed a literature search in PubMed from 2003 to 2013 using the search word “eosinophilic cystitis” 3. They studied 56 cases of EC.…”

“…Less frequent manifestations include urinary retention, gastrointestinal symptoms, incontinence, fever, skin rash, pneumaturia, and nocturnal enuresis. Patients with EC often have symptoms and clinical findings common to other urologic disorders, such as urinary tract infection, malignancy, and lower urinary symptoms 3. Although the etiology of the disease is unclear, allergies or bladder wall injury appear to be present in most cases 4.…”

BRAFmutation as a novel driver of eosinophilic cystitis

“…Although some cases can be associated with bladder infections or allergens, the underlying cause remains unclear. 6,7 Here we report the result of a liquid biopsy demonstrating a novel BRAF mutation in ctDNA from a patient with eosinophilic cystitis and show in silico modeling indicating functional impact of this alteration.…”

“…There is no curative treatment, and most patients are treated supportively with non-steroidal anti-inflammatory agents or steroids. 7 Cyclosporine has also been used. 16 For cases with severe refractory symptoms, transurethral resection of the bladder lesion can be performed in addition to systemic therapy, but lesions tend to recur in spite of therapy.…”