Obstructive Uropathy Complicating Eosinophilic Cystitis

Abstract

Eosinophilic cystitis is a rare clinicopathologic condition characterized by predominance of eosinophils throughout the bladder wall. The exact disease mechanism is still being debated. However, it is highly associated with atopy and other immunologic conditions. Reported here is a case of eosinophilic cystitis that presented with irritative voiding symptoms with right-sided flank pain, peripheral eosinophilia, and unilateral obstructive uropathy on imaging. Diagnosis was confirmed and documented with cystoscopy and bladder biopsy. Obstructive uropathy was managed with urinary diversion using double J stent. Immunologic signs and symptoms were treated with corticosteroid and antihistamine. Additionally, irritative voiding complaint was managed with antimuscarinic drug. Patient’s condition is now on remission with normal eosinophil count and creatinine levels, and normal urinalysis. Resolution of obstructive uropathy and bladder pathology were noted on follow up imaging and cystoscopy, respectively.