コウサンキュウ セイ ボウコウ エン ノ 1 レイ

症例は36歳男性.頻尿,排尿時痛,残尿感および食思不振を主訴に近医受診.抗生剤投与されるも症状軽快せず,当院紹介受診となる.初診時検査で,白血球,好酸球,IgEの上昇を認め,経腹膀胱超音波検査,MRIで膀胱壁の著明な肥厚を認めた.また,膀胱鏡検査では膀胱三角部を除く膀胱粘膜の著明な浮腫状所見を認め,上部消化管内視鏡検査では胃粘膜及び十二指腸粘膜も同様の浮腫状所見であった.確定診断のため膀胱全層針生検を施行し,病理所見では膀胱平滑筋内に著明な好酸球浸潤を認めたため好酸球性膀胱炎と診断.点滴ステロイド療法を開始し,症状軽快,画像上も改善を認めステロイド内服に切り替えたのち退院した.A 36-years-old man with pollakisuria and digestive symptom was referred to our hospital. A blood test showed inclease of serum white blood cell,eosinophil and IgE. Imaging study showed thickening of bladder wall, and endoscopy of bladder and stomach showed severe mucosal edema. Because there was a suspicion of the allergic diseases, we carried out transabdominal needle biopsy of bladder. Because of the pathological finding of severe eosinophilic infiltration into smooth muscle of urinary bladder, we diagnosed a case of eosinophilic cystitis. After that we started up steroid therapy immediately, he was recovering from pollakisuria and digestive symptom