Department of Paediatric Nephrology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Department of Paediatric Urology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Pediatr Nephrol. 2025 Jan;40(1):95-97. doi: 10.1007/s00467-024-06463-w. Epub 2024 Aug 16.
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.
我们报告了一例婴儿病例，其具有间歇性尿路梗阻、急性肾损伤、高血压和 4 型肾小管酸中毒（RTA）的特征，尽管进行了尿道插管和液体复苏。放射学检查结果显示上尿路扩张，可能为双侧输尿管膀胱连接部梗阻，膀胱底部增厚，这可能提示存在恶性肿瘤。肾活检显示嗜酸性粒细胞浸润，提示肾脏受累。膀胱活检诊断为嗜酸性膀胱炎（EC），表现为成熟的脱颗粒嗜酸性粒细胞。EC 是一种罕见的、易于治疗的疾病，也是儿童膀胱肿块的重要鉴别诊断，可能表现为非典型性尿路梗阻。本报告增加了该疾病在儿科人群中有限的文献资料。对于以嗜酸性粒细胞增多、尿路梗阻和肾功能障碍为表现且病因不明的儿童，应早期考虑 EC。本病例还强调了在疑似梗阻性尿路疾病的情况下，需要进行详细的影像学检查，包括膀胱底部的可视化。
