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Eosinophilic cystitis following cord blood transplantation: a form of acute GVHD. A variant of hemorrhagic cystitis after hematopoietic SCT or drug-induced?

Bone Marrow Transplantation volume 42, pages 495–496 (2008)Cite this article

Eosinophilic cystitis (EC) is a rare inflammation of the bladder that manifests as grossly thickened, edematous bladder wall with mucosal erythema and areas of plaque or ulceration on endoscopy. Histologically, EC involves transmural inflammation with a strong predominance of eosinophils in the bladder wall accompanied by fibrosis with or without muscle necrosis.1 Presentation is generally with urinary frequency, dysuria, urgency and hematuria.1 EC has not previously been reported in relation to hematopoietic stem cell transplantation (HST). Here, we describe an EC case following allogenic cord blood transplantation.

Hemorrhagic cystitis (HC) is a major cause of morbidity after HST. HC is a syndrome that might be defined clinically as macroscopic hematuria or sustained microhematuria for more than 14 days with clinical signs of cystitis de novo at least 10 days after HST, not with a tendency for generalized bleeding or bacteriuria HC.2 EC is an inflammatory bladder disease of unknown etiology that is diagnosed only on histological examination.1 Although EC can cause hematuria and seems to share some features with HC following HST, EC has not been reported in relation to HC following HST. This might be due to the difficulty in obtaining biopsy material for HC following HST, as most cases of HC following HST occur while thrombocytopenia is also present. One possible explanation for EC in our patient is that we were simply observing the pathological side of an ordinary episode of HC following HST, as our patient had adenovirus infection at the onset of EC.

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Authors and Affiliations

  1. First Department of Internal Medicine, Kagawa University, Kita-gun, Kagawa, Japan

    T Tasaka, Y Matsuhashi & H Ohnishi

  2. Department of Transfusion Medicine, Kagawa University, Kita-gun, Kagawa, Japan. E-mail: taizo@med.kawasaki-m.ac.jp or tasaka206@aol.com,

    Y Kubota

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  1. T Tasaka
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  2. Y Matsuhashi
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Tasaka, T., Matsuhashi, Y., Ohnishi, H. et al. Eosinophilic cystitis following cord blood transplantation: a form of acute GVHD. A variant of hemorrhagic cystitis after hematopoietic SCT or drug-induced?. Bone Marrow Transplant 42, 495–496 (2008). https://doi.org/10.1038/bmt.2008.192

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