Eosinophilic food-induced cystitis

In this work we study a case of eosinophilic cystitis induced by the ingestion of some specific foodstuffs (tomatoes, coffee, carrots) and strong smells (petrol) in a female patient with clinical history of extrinsic permanent rhinitis and Quincke's oedema. Skin tests and RAST showed specific antibodies against Dermatophagoides Pteronyssimus, Farinae, Alternaria and Cladosporium. These antigens were related to the rhinosinusitis and facial oedema. Provocative tests were used to make the definitive diagnosis. They were carried out when the patient was symptomless and the following parameters were taken into account: the time elapsed estil the appearance of the symptoms, the intensity of urinary symptoms, polakiuria, urgency and prepubic pain, cystoscopy, bladder histology, urine volume and pre-and post-test histaminuria in 24 hours. Bladder histology subsequent to the intake of tomato showed capillary congestion and severe inflammatory infiltration with a clear predominance of eosinophils. The histaminuria values after the ingestion of tomatoes, carrots and coffee were superior to basal determinations, amounting to a maximum of 1229 mcg./l. in 24 hours. The allergic origin of these eosinophilic cystitis is proved by the appearance of urologic symptoms and eosinophilic infiltration of the bladder subsequent to provocative tests, which subside when the antigens which bring them about are removed.