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Severe interstitial cystitis associated with Sjögren's syndrome
Shigeru Shibata1, Yoshifumi Ubara, Naoki Sawa
1Nephrology Center, Toranomon Hospital, Tokyo.
Internal Medicine (Tokyo, Japan)
|April 22, 2004
Summary
Sjögren's syndrome can cause severe interstitial cystitis, leading to urinary obstruction. Treatment with corticosteroids and cyclosporin improved bladder function and symptoms in a case study.
Area of Science:
- Nephrology
- Rheumatology
- Urology
Background:
- Sjögren's syndrome is a chronic autoimmune disease primarily affecting exocrine glands.
- Interstitial cystitis (IC) is a chronic bladder pain disorder.
- Co-occurrence of Sjögren's syndrome and IC can lead to complex urological manifestations.
Observation:
- A 53-year-old woman presented with acute kidney injury, oliguria, and lower extremity edema.
- Imaging revealed severe hydroureteronephrosis and a distended bladder.
- Biopsies confirmed chronic sialoadenitis and subepithelial edema with inflammatory cell infiltration in the bladder.
Findings:
- The patient was diagnosed with Sjögren's syndrome complicated by severe interstitial cystitis.
- Initial management included intermittent self-catheterization due to anuria.
- Combination therapy with corticosteroids and cyclosporin resulted in improved bladder capacity and spontaneous urination.
Implications:
- This case highlights the potential for severe urinary tract obstruction in Sjögren's syndrome-associated IC.
- Corticosteroids and cyclosporin may be effective therapeutic options for managing severe IC in the context of Sjögren's syndrome.
- Early diagnosis and multimodal treatment are crucial for improving outcomes in such complex cases.