背景:嗜酸性粒细胞性膀胱炎(EC)在儿童中很少见,并且仍然知之甚少。我们的目的是分析儿童嗜酸性膀胱炎的临床和影像学特征。
方法:对2008年1月至2022年12月间经组织学证实的嗜酸性粒细胞性膀胱炎进行了回顾性回顾,包括患者年龄,性别,症状,实验室检查,放射学,治疗和结果。
结果:十二个孩子(两个女孩,10个男孩;年龄范围:3-12岁,平均年龄:7.2岁)纳入研究。尿液刺激症状(10/12),血尿(5/12)和下胃痛(3/12)是最常见的症状。五名患者有过敏史,6例患者血清IgE升高,9例患者外周嗜酸性粒细胞升高,6例患者镜下血尿阳性.放射学显示7例患者弥漫性均匀或不均匀增厚,三名患者的局部增厚,和其他两名患者的孤立肿瘤样病变。在11例患者中观察到粘膜线保留和膀胱壁分层,10例患者膀胱周围渗出和小血管扩张。所有4例延迟扫描的患者均显示明显的延迟增强。一名患者在T2-W成像上显示低信号强度。所有患者都接受了抗组胺药,抗生素和/或皮质类固醇治疗和两名肿瘤样患者接受了经尿道切除术。9名患者获得完全响应,3名患者获得部分响应。
结论:儿童EC的临床和影像学表现具有相关特征;当泌尿科医生和放射科医生遇到类似病例时,应该考虑EC。最终诊断取决于病理活检。
BACKGROUND: Eosinophilic cystitis (EC) is rare in children and remains poorly understood. Our aim was to analyse the clinical and imaging features of eosinophilic cystitis in children.
METHODS: A retrospective review of histologically confirmed eosinophilic cystitis between January 2008 and December 2022 was performed, including patient age, sex, symptoms, laboratory examination, radiology, treatment and outcome.
RESULTS: Twelve children (two girls, 10 boys; age range: 3-12 years, mean age: 7.2 years) were included in the study. Urinary irritation symptoms (10/12), haematuria (5/12) and hypogastralgia (3/12) were the most common symptoms. Five patients had a history of allergies, six patients had elevated serum IgE, nine patients had elevated peripheral eosinophils and six patients had positive microscopic haematuria. Radiology revealed diffuse homogeneous or inhomogeneous thickening in seven patients, localised thickening in three patients, and solitary tumour-like lesions in the other two patients. Preservation of the mucosal line and bladder wall layering were observed in eleven patients, and perivesical exudation and small vessel dilatation were observed in ten patients. All four patients with delayed scans showed obvious delayed enhancement. One patient showed low signal intensity on T2-W imaging. All patients received antihistamine, antibiotic and/or corticosteroid therapy and two tumour-like patients underwent transurethral resection. Nine patients achieved complete response and three patients achieved partial response.
CONCLUSIONS: The clinical and imaging manifestations of EC in children have relative characteristics; when urologist and radiologist confronted with similar cases, EC should be considered. The final diagnosis depends on pathological biopsy.