Lupus cystitis: unusual cause of renal failure in systemic lupus erythematosus

John, Kevin John; Varughese, Krupa; Boaz, Ranil Johann; George, Tarun K

doi:10.1136/bcr-2019-233446

Cited by 6 publications

(3 citation statements)

References 25 publications

(18 reference statements)

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“… 2 In patient 2, we considered that bilateral ureteral dilation and hydronephrosis resulted from just the bladder contraction. In patients with lupus cystitis, the urinary tract is commonly dilated 3 , 4 , 5 but stenosis has been seen in rare case. 6 , 7 Physicians should be careful in diagnosing it.…”

Section: Discussionmentioning

confidence: 99%

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

Abe

Kawamata

Makiyama

et al. 2023

Immunity Inflam & Disease

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Objectives Lupus cystitis is a rare but serious complication of systemic lupus erythematosus (SLE) that can cause permanent bladder dysfunction, leading to irreversible deterioration of kidney function. We report two cases of SLE with lupus cystitis who showed different images from the same cause of disease. Methods Patient 1, a 67‐year‐old woman diagnosed with SLE presented with persistent dysuria for 3 weeks with sudden headache and vomiting. She was hospitalized because of acute kidney injury; the serum creatinine level was 10.68 mg/dL. Computed tomography (CT) showed significant bilateral ureteral stenosis and bilateral hydronephrosis. Patient 2, a 45‐year‐old woman diagnosed with SLE presented with dysuria requiring self‐catheterization. CT showed significant bilateral ureteral dilatation and bilateral hydronephrosis. Results In patient 1, the right kidney was afunctional. Left nephrostomy was performed on Day 2. Her serum creatinine returned to the normal range. In patient 2, After admission, she changed to an indwelling bladder catheter. Her serum creatinine level improved from 2.04 to 1.31 mg/dL. Conclusion In patients with lupus cystitis, the urinary tract is commonly dilated, but stenosis has been seen in rare case. Physicians should be careful in diagnosing it.

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Section: Discussionmentioning

confidence: 99%

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

Abe

Kawamata

Makiyama

et al. 2023

Immunity Inflam & Disease

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show abstract

“…Lupus cystitis and damage to the ureters is a relatively rare complication of SLE, and its clinical features remain obscure. 1,3,6–9 Generally, ureteritis refers to inflammatory changes in the ureter caused by bacterial invasion, and it mainly manifests as lower back pain, hematuria, fever, and urinary irritation. However, the underlying pathological basis of SLE-associated ureteritis is vasculitis.…”

Section: Discussionmentioning

confidence: 99%

Ureteritis associated with systemic lupus erythematosus: a case report

Huang

Wang

et al. 2021

J Int Med Res

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We report herein an unusual case of systemic lupus erythematosus in a 35-year-old woman who developed acute abdominal pain while hospitalized. Abdominal computed tomography (CT) scan with enhancement indicated long-segment inflammatory lesions in the right ureter. The patient received spasmolytic and analgesic drugs with poor effect and continued to have persistent severe abdominal pain and signs of peritonitis. We suspected that the patient had acute abdominal disease, but no abnormality was detected during laparoscopic surgery. Therefore, we considered the possibility of right upper urinary tract hydronephrosis; the patient’s abdominal pain was relieved after double-J tube implantation. The patient’s clinical symptoms improved after hormone and mycophenolate mofetil therapy for 1 year, and all laboratory indicators returned to normal. Reexamination by abdominal CT showed that the long-segment inflammatory lesions of the right ureter had resolved. Early identification and diagnosis are important for ureteritis associated with systemic lupus erythematosus.

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“…Frequency, dysuria, nocturia, and lower abdominal pain are the cardinal symptoms of cystitis, achieving some improvement during urination [ 16 ]. Urinalysis is usually normal in most cases, although the presence of hematuria is occasionally observed [ 17 ]. A serious consequence of lupus cystitis is hydroureteronephrosis, which occurs as a result of the reduction of the vesicoureteral outlet space caused by inflammatory edema and fibrosis [ 18 ].…”

Section: Reviewmentioning

confidence: 99%

Lupus Cystitis, From Myth to Reality: A Narrative Review

Santacruz¹,

Pulido²,

Arzuaga³

et al. 2021

Cureus

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Systemic lupus erythematosus is a multisystemic disease that usually involves the urinary tract, often in the form of lupus nephritis. However, another form of compromise of this system is lupus cystitis, which, despite being an unusual condition, turns out to be a challenging diagnosis due to the spectrum of nonspecific abdominal and urinary symptoms. Although the exact pathophysiological mechanism of bladder inflammation remains to be established, the role of small vessel vasculitis measured by immune complexes continues to be supported as a central axis for considering possible therapeutic targets. Additionally, there are no clinical studies that dictate a guideline regarding its treatment, however, the evidence from most cases described in the literature suggests the initiation of pulses of methylprednisolone and cyclophosphamide in treatment regimens similar to those of lupus nephritis. Despite its low prevalence, obstructive complications and kidney damage can lead to increased morbidity and mortality.

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Lupus cystitis: unusual cause of renal failure in systemic lupus erythematosus

Cited by 6 publications

References 25 publications

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

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

Ureteritis associated with systemic lupus erythematosus: a case report

Lupus Cystitis, From Myth to Reality: A Narrative Review

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