Eosinophilic ureteritis

Last revised by Matt A. Morgan on 25 May 2021

Eosinophilic ureteritis (and eosinophilic pyelouerteritis) is a rare cause of ureteral inflammation. The clinical presentation and imaging features are non-specific.

Patients are usually atopic or hypereosinophilic with peripheral eosinophilia.

Associated with eosinophilic infiltration of other organs, including eosinophilic cystitis.

Histopathology shows a ureteral stricture with intense eosinophilic infiltrate. Some think that this entity was previously conflated with an older diagnosis of "idiopathic segmental ureteritis", but that the two entities are separate 1.

The condition usually manifests as a ureteral stricture. The imaging is otherwise non-specific.

This is a rare diagnosis and should only be considered in the setting of a patient with a negative workup for urothelial carcinoma and tuberculosis, and with hypereosinophilia and possible eosinophilic involvement of other organs.

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