Intravesical Dimethyl Sulfoxide Instillations in the Treatment of Secondary Amyloidosis of the Bladder

Abstract

A-22-year-old woman with long-standing rheumatoid arthritis and secondary amyloidosis of the bladder had recurrent profuse macroscopic hematuria. She was treated with intravesical dimethyl sulfoxide instillation every 2 weeks for 1 year. She remained asymptomatic during the treatment and at 6 months. Progressive disappearance of amyloid from the superficial mucosa of the bladder was demonstrated in sequential histological examinations.

Obstructive nephropathy secondary to AA-type amyloidosis in ankylosing spondylitis

“…16 Treatment has also been applied with colchicine as well as vesical instillations with dimethylsulfoxide following surgery with the purpose of breaking down the residual amyloid deposit. 16,17 As often as possible, systemic therapy must be associated by controlling the underlying disease process. New therapeutic approaches, in particular antitumor necrosis factor (anti-TNF) alpha agents are promising in inducing clinical remission by suppressing systemic inflammation in AA amyloidosis.…”

Primary amyloidosis of urinary bladder: Mimicking transitional cell carcinoma bladder?

“…Medical treatment with substances such as colchicines 9 nitrofuazone and dimethyl sulfoxide 10 as primary or adjuvant therapy has been tried for symptomatic relief. Cystectomy may be required in diffuse bladder involvement.…”

Der Amyloidtumor der Harnblase - eine seltene Ursache der Makrohämaturie

“…Sowohl in den vorgestellten Fällen wie auch in der Literatur manifestiert sich die Blasenamyloidose meist durch eine starke, rezidivierende, vornehmlich schmerzlose Makrohämaturie (1,11,13,(15)(16)(17)(18)(19)(20)(23)(24)(25). In der sich in den meisten Fällen anschließenden Zystoskopie erscheint die Blasenamyloidose als Anhäufung von gelblichen, bis kirschkerngroßen Tumoren, die teilweise exulzeriert sind.…”

“…In der Literatur wird von sehr unterschiedlichen Erfahrungen mit der Therapie der Blasenamyloidose berichtet. Das Spektrum reicht von watchful-waiting, rezidivierenden transurethralen Resektionen, medikamentösen Instillationstherapien bis zur Zystektomie mit Harnableitung (1,(11)(12)(13)(17)(18)(19)(20)(23)(24)(25). Einige Autoren beschreiben gute Ergebnisse bei der Therapie mit Dimethylsulfoxid (DMSO) (17,28).…”