Cistitis eosinofílica: ruptura vesical espontánea recurrente en un adulto

Introduccion: La cistitis eosinofilica descrita por primera vez en 1960 por Brown, corresponde a una patologia inflamatoria de la vejiga muy infrecuente, de etiologia especifica aun incierta. Puede variar desde inflamacion moderada, hasta vejiga fibrotica con dilatacion pielocalicilar y grados variables de insuficiencia renal. Si bien, tiene una presentacion clinica variable, no se ha descrito previamente en la literatura la perforacion vesical espontanea recurrente. Caso clinico: Presentamos el caso de una mujer de 35anos con historia de hematuria, poliquiuria, tres perforaciones vesicales espontaneas y microvejiga fibrotica con hidroureteronefrosis bilateral que se maneja finalmente con ampliacion vesical con segmento de ileon y ademas, exponemos una revision actualizada de la literatura. Conclusion: La cistitis eosinofilica es una entidad de etiologia incierta, con una historia natural impredecible. Su incidencia y prevalencia son desconocidas y si bien, no ha sido descrita previamente en un adulto en nuestro medio, es recomendable considerarla entre los diagnosticos diferenciales de una hematuria macroscopica o sindrome de irritacion vesical persistente. La ruptura vesical espontanea recurrente es una presentacion clinica no descrita previamente en la literatura. Se deben continuar periodicamente controles imagenologicos y de laboratorio y su tratamiento aun no esta estandarizado.(AU) Introduction: Eosinophilic cystitis was first described in 1960 by Brown, it is an inflammatory disease of the bladder that is extremely rare where etiology remains uncertain. It ranges from a mild inflammation to a fibrotic bladder with pielocalycilar dilatation and varying degrees of renal failure. While it has a variable clinical presentation, recurrent spontaneous bladder perforation has not been described previously in the literature. Case report: We report the case of a 35 years old women with a history of hematuria, polyaquiuria, three spontaneous bladder perforations and fibrotic microbladder with bilateral hydroureteronephrosis that is finally managed by bladder augmentation made of an ileum segment. Additionally, we present an updated revision of the literature. Conclusion: Eosinophilic cystitis is an entity of unknown etiology with an unpredictable evolution. Incidence and prevalence are unknown and although it has not been previously reported in our adult patients, it should be considered as differential diagnosis of gross hematuria or persistent bladder irritation syndrome. Recurrent spontaneous bladder rupture is a clinical presentation not previously described in the literature. Periodic monitoring and laboratory imaging should be established and treatment is not yet standardized.(AU)