Abstract：
We report on an infant with features of intermittent obstructive uropathy, acute kidney injury, hypertension and type 4 renal tubular acidosis (RTA) despite urethral catheterisation and fluid resuscitation. Radiological findings showed upper tract dilatation, likely bilateral vesicoureteric junction obstruction and bladder base thickening which was concerning for possible malignancy. Renal biopsy demonstrated eosinophilic infiltrate, suggestive of kidney involvement. Bladder biopsy was diagnostic for eosinophilic cystitis (EC) showing mature degranulating eosinophils. EC is a rare, easily treatable and important differential of bladder mass in children which may present with an atypical obstructive uropathy. This report adds to the limited literature of this condition within the paediatric population. EC should be considered early in children presenting with eosinophilia, urinary tract obstruction and kidney dysfunction, with uncertain aetiology. This case also highlights the need for detailed imaging, including visualisation of the bladder base, in cases of likely obstructive uropathy.
摘要：
我们报道了一个有间歇性阻塞性尿路病特征的婴儿，急性肾损伤，高血压和4型肾小管酸中毒（RTA），尽管尿道插管和液体复苏。放射学检查结果显示上束扩张,可能是双侧膀胱输尿管交界处梗阻和膀胱基底增厚，这可能是恶性肿瘤。肾活检显示嗜酸性粒细胞浸润，提示肾脏受累。膀胱活检可诊断为嗜酸性粒细胞性膀胱炎（EC），显示成熟的脱粒嗜酸性粒细胞。EC是一种罕见的，儿童膀胱肿块易于治疗且有重要区别，可能伴有非典型阻塞性尿路病变。该报告增加了儿科人群中这种情况的有限文献。在出现嗜酸性粒细胞增多的儿童中，应及早考虑EC。尿路梗阻和肾功能障碍，病因不确定。这个案例也突出了对详细成像的需要，包括膀胱基底的可视化，在可能的阻塞性尿路病变的情况下。
