eosinophilic cystitis
Introduction
Introduction to eosinophilic cystitis Eosinophilic cystitis (eosinophilic cystitis) is a disease caused by allergic reaction of eosinophils in the bladder. The cause is unclear. Most people think that it is related to bacteria, drugs, allogeneic proteins and food allergens. basic knowledge The proportion of illness: 0.002% Susceptible people: no special people Mode of infection: non-infectious Complications: urinary tract obstruction
Cause
Causes of eosinophilic cystitis
(1) Causes of the disease
The etiology of eosinophilic cystitis is unclear, but it is thought to be related to various stimuli such as bacteria, drugs, allogeneic proteins and food allergens. These allergens act as immunostimulants and form immunity in the bladder. The complex causes infiltration of eosinophils, destroys bladder tissue, and then causes release of lysosomes, which further aggravates bladder inflammation. Food allergens that may be associated with this disease include: oranges, tomatoes, chocolate, tea, coffee, cocoa , milk, a variety of condiments, etc., some patients found that in the diet to stop the above foods and beverages, the symptoms are significantly reduced, the number of attacks is significantly reduced, the drugs may be related to sulfa drugs, dicoumarin sodium, Sodium salicylate, etc., in addition, condoms, vaginal suppositories and spermicidal jelly can be contact allergens, schistosomiasis eggs deposited on the bladder wall, can form schistosomiasis eosinophilic granuloma, drugs and food allergens It is easy to cause diffuse cystitis, and the damage caused by parasites is local.
(two) pathogenesis
Bladder mucosa erythema, edema, ulcers, velvety-like changes, such as papilloma and grape sarcoma in the case of proliferative lesions, sometimes nodules of soy or mung bean size, or fine-grained protrusions, lower end of the ureter The affected narrows, can cause bilateral renal ureteral hydrops, biopsy found fibrosis, local necrosis, a large number of eosinophilic infiltration in the bladder layer, and some are eosinophilic granuloma of the bladder.
Prevention
Prevention of eosinophilic cystitis
Although the cause of this disease is still unclear, it is important to find the cause of sensitization and reduce or avoid antigenic stimulation as an important measure to prevent this disease.
Complication
Eosinophilic cystitis complications Complications, urinary tract obstruction
When the lesion involves the bilateral lower ureter, it can cause upper urinary tract obstruction and water complications.
Symptom
Eosinophilic cystitis symptoms Common symptoms Ureteral dilatation, urinary urinary frequency, urinary urgency, pyuria, pyuria
Hematuria or pyuria, frequent urination, urgency, dysuria, dysuria are not relieved by urination, dysuria, severe cases even have urinary retention, symptoms often recurrent and tend to be chronic, patients often have a history of allergies or asthma.
Examine
Examination of eosinophilic cystitis
Blood routine examination may have eosinophilia, urine routine examination showed proteinuria, hematuria or pyuria, and middle urine culture was negative.
1. IVU can show ureteral dilatation or reflux.
2. Cystoscopy revealed a broad-based new organism in the bladder, mostly located in the posterior wall of the bladder and around the ureteral orifice. Biopsy can help to establish the diagnosis. Pathological examination showed a large amount of eosinophil infiltration in the bladder mucosa.
Diagnosis
Diagnosis and differentiation of eosinophilic cystitis
diagnosis
Have a history of allergies or asthma; recurrent chronic bladder irritation; peripheral blood eosinophilia; urine test with proteinuria, hematuria or pyuria; middle urine culture negative; IVU can show ureteral dilatation or reflux, cystoscopy and taking Confirmed by biopsy.
Differential diagnosis
Acute cystitis
Can also be expressed as frequent urination, urgency, dysuria and other bladder irritation, and even hematuria, but often urinary frequency, urgency, and there can be a lot of white blood cells in the urine, no history of allergies or asthma, blood routine examination without hobby Acidic granulocytes increase, and hematuria can be quickly disappeared by antibiotics.
2. Glandular cystitis
It also manifests as urinary frequency, urgency, dysuria and other symptoms of bladder irritation, but there is no eosinophilia in the peripheral blood, nipples can be seen in the cystoscope, but not in the broad-based new organism. The biopsy can confirm the diagnosis.
3. Interstitial cystitis
It also manifests as urinary frequency, urgency, dysuria and other symptoms of bladder irritation, but the frequency of urination is obvious day and night, especially when there is severe pain in the filling of the bladder, and the symptoms are relieved after urination. The superficial ulcer can be seen in cystoscopy, instead of Guangjixin. Biological, biopsy can confirm the diagnosis.
