Allergic haematuria.

Allergic reactions are only rarely taken into consideration in the differential diagnosis of urological disorders (Campbell, 1951; Dees and Simmons, 1951). Histologically speaking, however, allergic reactions are just as capable of occurring in the urinary tract as they are in the respiratory or digestive tracts. Thus mast cells and histamine are to be found everywhere in the normal bladder wall (Simmons, 1961). The far greater incidence of allergies of the respiratory passages and, less commonly, of the intestine is no doubt due to the fact that these organs are directly exposed to all possible kinds of allergens, whereas the urinary passages are protected by the body coverings, by the metabolism, and by humoral antibodies. Since Duke (1922) published his findings regarding bladder pains of allergic origin only occasional reports of similar symptoms have appeared. In a general review of the subject, Powell (1961) gives a list of symptoms that might be caused by an allergic reaction of the urinary passages. The symptoms given range from tenesmus and dysuria via haematuria to suprapubic pains and pains in the side. Cystoscopy in such cases frequently reveals a pale, oedematous mucosa with hyperaemic zones. Allergens mentioned include inhalants, drugs, foods, and causative organisms of infections. In the case of food allergy, symptoms of urinary tract reaction were observed 1 to 12 hours after ingestion of the food. Powell makes the interesting observation that allergic bladder and prostate disorders occur with greater frequency during holiday periods, i.e. when unaccustomed foods are on the table. Citrus fruits head the list of allergenic substances, followed by tomatoes, spices, chocolate, and nuts. More recently interstitial cystitis, in particular, has been assigned an allergic origin, and an account has been given of successful treatment with antihistamines (Simmons, 1961). Besides haematuria in Henoch-Schonlein purpura, which is almost certainly of allergic origin, and other allergic glomerular lesions, there is also an isolated form of allergic haematuria, which is