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[Eosinophilic cystitis in children]
J C Hoeffel1, G De Miscault, B Aymard
1Service de radiologie, Hôpital d'Enfants, Vandoeuvre-les-Nancy.
Insights
Eosinophilic cystitis, a rare condition mimicking bladder cancer, can cause urinary infections and ureteral obstruction. Prompt diagnosis via biopsy and specific treatment can lead to healing, even without parasitic infection.
Area of Science:
- Pediatric Urology
- Pathology
- Infectious Diseases
Background:
- Recurrent urinary infections in children can indicate underlying pathology.
- Pseudotumoral forms of cystitis are rare and can mimic malignancy.
- Ureteral obstruction in children necessitates thorough investigation.
Observation:
- A 4-year-old boy presented with recurrent urinary infections and left ureterohydronephrosis.
- Initial biopsies were required to exclude a malignant tumor.
- The condition was diagnosed as eosinophilic cystitis.
Findings:
- Eosinophilic cystitis presented as a pseudotumoral mass causing bladder inflammation and ureteral obstruction.
- Anti-bilharzial treatment led to complete healing.
- The patient did not have a history of bilharziasis (schistosomiasis).
Implications:
- Eosinophilic cystitis should be considered in the differential diagnosis of pediatric bladder masses and urinary tract infections.
- Biopsy is crucial for accurate diagnosis, especially when initial findings are inconclusive.
- Successful treatment with anti-bilharzial agents is possible even in non-parasitic cases, suggesting broader anti-inflammatory mechanisms.
Abstract:
In a 4-year-old boy, cystitis in a pseudotumoral form with left ureterohydronephrosis wa discovered on the occasion of repeated urinary infections. Several biopsies were required to rule out a malignant tumor, and they showed that this condition was an eosinophilic cystitis. Healing was obtained with an anti-bilharzial treatment, although this child did not suffer form bilharziasis. A few similar cases were found in the literature. We note that the diagnosis is usually not established before biopsy, but the association of repeated urinary infections and of a vesical pseudotumoral syndrome with ureteral obstruction must lead to suggesting it, especially if the first biopsy does not reveal any tumor.