Boon's disease: Hemorrhagic cystitis in conjunction with massive exfoliation of degenerated urothelial cells (apoptosis?) during intercontinental flights in an otherwise healthy person

Hemorrhagic cystitis is a well-defined clinical emergency, usually occurrin g in the course of treatment with toxic agents such as cyclophosphamide. We present a case of hemorrhagic cystitis in an otherwise completely healthy female. The three documented attacks it-ere severe and started during inter continental flights. This type of hemorrhagic cystitis as a disease proved to be a boon, treatable by drinking large amounts of water, and was diagnos ed by and in Dr. Boon; thus was the appellation Boon's disease coined. Cell ular changes in the urine specimen taken after onset of the disease indicat ed massive exfoliation of degenerated urothelial cells with morphological f eatures suggestive of apoptosis. It seems likely that this process can be i nitiated by any event which is associated with compromise of vitality of th e urinary bladder lining, such as may occur in hypovolemia. This type of he morrhagic cystitis is most probably not uncommon in susceptible individuals during intercontinental flights. (C) 2001 Wiley-Liss, Inc.