Child Kidney Dis.  2015 Oct;19(2):167-170. 10.3339/chikd.2015.19.2.167.

A Case of Hypereosinophilic Syndrome with Bladder Involvement in a 7-Year-Old Boy

• Park YK
• Yim HE
• Yoo KH

• KMID: 2168419
• DOI: http://doi.org/10.3339/chikd.2015.19.2.167

Abstract

Hypereosinophilic syndrome (HES) is characterized by the presense of hypereosinophilia with evidence of target organ damage. We report a patient diagnosed with eosinophilic cystitis and HES. A 7 year old boy had hematuria, dysuria, and increased urinary frequency for 1 day. Laboratory examinations revealed hypereosinophilia (eosinophils, 2,058/microL), hematuria, and proteinuria. Abdominal sonography revealed diffuse and severe wall thickening of the bladder. The patient was treated initially with antibiotics. However, his symptoms did not improve after 7 days. A computed tomography scan demonstrated severe wall thickening of the bladder and the hypereosinophilia persisted (eosinophils, 2,985/microL). The patient complained of chest discomfort, dyspnea, epigastric pain, and vomiting on hospital day 10. Parasitic, allergic, malignancy, rheumatologic, and immune workups revealed no abnormal findings. Chest X-rays, electrocardiography, and a pulmonary function test were normal; however, the hypereosinophilia was aggravated (eosinophils, 3,934/microL). Oral deflazacort was administered. A cystoscopic biopsy showed chronic inflammation with eosinophilic infiltration. The patient's respiratory, gastrointestinal, and urinary symptoms improved after 6 days of steroids, and he was discharged. The eosinophil count decreased dramatically (182/microL). The hypereosinophilia waxed and waned for 7 months, and the oral steroids were tapered and stopped. This case describes a patient diagnosed with eosinophilic cystitis and HES.

Keyword

Hypereosinophilic syndrome; Eosinophilic cystitis; Hypereosinophilia

MeSH Terms

Anti-Bacterial Agents
Biopsy
Child*
Cystitis
Dyspnea
Dysuria
Electrocardiography
Eosinophils
Hematuria
Humans
Hypereosinophilic Syndrome*
Inflammation
Male*
Proteinuria
Respiratory Function Tests
Steroids
Thorax
Urinary Bladder*
Vomiting
Anti-Bacterial Agents
Steroids