In lupus cystitis, is the urinary tract dilated or obstructed?

Area of Science:

• Nephrology
• Rheumatology
• Urology

Background:

• Systemic lupus erythematosus (SLE) can lead to lupus cystitis, a rare but severe bladder complication.
• Lupus cystitis may cause permanent bladder dysfunction and irreversible kidney damage.

Observation:

• Two cases of SLE with lupus cystitis presented with distinct imaging findings.
• Patient 1 exhibited ureteral stenosis and hydronephrosis, while Patient 2 showed ureteral dilatation and hydronephrosis.

Findings:

• Patient 1 underwent nephrostomy for a non-functional kidney, leading to creatinine normalization.
• Patient 2 improved with an indwelling catheter, showing reduced creatinine levels.

Implications:

• Lupus cystitis imaging can vary, with stenosis being a rare presentation.
• Accurate diagnosis of lupus cystitis is crucial for effective management and preventing kidney deterioration.