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Systemic lupus erythematosus relapse with lupus cystitis
Y Nakauchi1, T Suehiro, K Tahara
1Second Department of Internal Medicine, Kochi Medical School, Japan.
Clinical and Experimental Rheumatology
|September 1, 1995
Summary
Systemic lupus erythematosus (SLE) can manifest as lupus cystitis, causing severe urinary symptoms and acute kidney injury. Early recognition and treatment with corticosteroids are crucial for managing this specific SLE complication.
Area of Science:
- Nephrology
- Rheumatology
- Urology
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical presentations.
- Urinary tract involvement in SLE commonly includes lupus nephritis, but other manifestations are less understood.
Observation:
- A 45-year-old woman with a history of SLE in remission presented with severe urinary frequency, diarrhea, vomiting, and weight loss.
- She developed acute renal failure, hydroureteronephrosis, and a markedly decreased bladder capacity (20 ml).
- Urinary bladder biopsy revealed IgA deposition, inflammation, and edema, consistent with lupus cystitis.
Findings:
- Histopathological analysis confirmed lupus cystitis, characterized by IgA deposition in the bladder epithelium and submucosa.
- The patient's symptoms improved significantly with bilateral nephrostomy and corticosteroid therapy.
- This presentation highlights lupus cystitis as a distinct clinical manifestation of SLE, potentially without typical systemic symptoms.
Implications:
- Lupus cystitis should be considered in SLE patients presenting with unexplained lower urinary tract symptoms and renal dysfunction.
- Prompt diagnosis and immunosuppressive therapy, particularly corticosteroids, can effectively manage lupus cystitis.
- Recognizing lupus cystitis expands the understanding of SLE's multi-organ involvement and guides targeted patient management.