论文部分内容阅读
目的探讨儿童嗜酸细胞性膀胱炎临床表现、实验室检查、影像学和病理学特点、诊治要点及预后情况。方法回顾性分析2012年1月至2015年5月中国医科大学附属盛京医院小儿肾脏风湿免疫科及小儿泌尿外科收治的4例儿童嗜酸细胞性膀胱炎的临床资料。结果 4例患儿均为男性,年龄6~8岁,主要临床症状为尿频、尿痛、排尿困难、耻骨上疼痛、血尿,4例均出现外周血嗜酸性粒细胞增高,影像学主要表现为膀胱壁增厚,2例经膀胱镜、2例经开腹手术取膀胱组织行膀胱病理活检,病理显示膀胱间质嗜酸性粒细胞浸润。口服糖皮质激素和抗组胺药物治疗后,临床症状缓解,外周血嗜酸性粒细胞及膀胱影像学改变均恢复正常。4例中3例病情反复,糖皮质激素总疗程3个月至1年6个月,1例停药2年无复发,2例复发1次、1例复发2次。结论嗜酸细胞性膀胱炎确诊依靠膀胱病理诊断,患者外周血嗜酸性粒细胞增高及膀胱壁增厚对诊断有提示作用,糖皮质激素治疗本病有效,需要长期密切随访。
Objective To investigate the clinical manifestations, laboratory tests, imaging features and pathological features of children with eosinophilic cystitis, diagnosis and treatment of key points and prognosis. Methods The clinical data of 4 children with eosinophilic cystitis admitted to Department of Pediatric Nephrology and Pediatric Urology, Shengjing Hospital, China Medical University from January 2012 to May 2015 were retrospectively analyzed. Results All the 4 children were male, aged 6 to 8 years old. The main clinical symptoms were frequent urination, dysuria, dysuria, suprapubic pain and hematuria. The peripheral blood eosinophilia was found in all 4 cases. The main manifestations were Bladder wall thickening, 2 cases of cystoscopy, 2 cases of bladder tissue taken by laparotomy bladder biopsy, pathology showed bladder interstitial eosinophil infiltration. Oral corticosteroids and antihistamines treatment, clinical symptoms, peripheral blood eosinophils and bladder imaging changes returned to normal. In 3 of 4 cases, the condition was repeated. The total duration of glucocorticoid treatment ranged from 3 months to 1 year and 6 months. One patient discontinued without relapse for 2 years, 2 patients relapsed one time and 1 patient relapsed twice. Conclusion The diagnosis of eosinophilic cystitis depends on the diagnosis of bladder pathology. The increase of eosinophils in the peripheral blood and the thickening of the bladder wall may be helpful for the diagnosis. Glucocorticoid treatment is effective and requires long-term and close follow-up.