Successful treatment of lupus erythematosus cystitis with DMSO

Sotolongo, Jose R.; Swerdlow, Frederick; Schiff, Howard I.; Schapira, Hans E.

doi:10.1016/0090-4295(84)90004-9

Cited by 12 publications

(7 citation statements)

References 16 publications

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“…The treatment of isolated lupus cystitis has included high doses of corticosteroids, dimethyl sulfoxide, cyclosporin A, and formalin [17]. The prognosis of lupus CIC is related to the morbidity and mortality associated with bowel perforation and infectious complications.…”

Section: Urological Complications Of Slementioning

confidence: 99%

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Genitourinary complications of systemic lupus erythematosus

Meyers¹,

Pfieffer

et al. 2000

Pediatr Nephrol

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A 14-year-old African-American girl was diagnosed with antiphospholipid-positive systemic lupus erythematosus (SLE) in July 1994. The course was complicated by nephrotic syndrome, sepsis, hemolytic anemia, acute renal failure, saphenous vein thrombosis, cutaneous vasculitis, mesenteric vasculitis, appendicitis, hemorrhagic cystitis, and avascular necrosis of the hips. In August 1997, she developed ovarian and fallopian tube complications secondary to SLE. Genitourinary complications of SLE, however, are uncommon, and ovarian vasculitis has not previously been reported as a complication of SLE. This report describes the course of an adolescent patient with SLE and focuses specifically on her genitourinary complications.

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Section: Urological Complications Of Slementioning

confidence: 99%

“…Cyclophosphamide-induced hemorrhagic cystitis is often temporally related to therapy. Removal of the offending agent is often sufficient, but severe hemorrhage may require use of locally instilled therapy [17,25]. How can one differentiate SLE cystitis from a culturenegative viral cystitis?…”

Section: Questions and Answersmentioning

confidence: 99%

Genitourinary complications of systemic lupus erythematosus

Meyers¹,

Pfieffer

et al. 2000

Pediatr Nephrol

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“…Corticosteroid therapy is most commonly recommended as first-line treatment; the reported response rate is 59% 2. Other suggested treatments include the addition of cyclophosphamide,5 replacement with cetirizine hydrochloride2 or intravesical dimethyl sulphoxide (DMSO) 6. Some patients may develop irreversible obstruction despite pharmacological management 5.…”

Section: Discussionmentioning

confidence: 99%

“…2 Other suggested treatments include the addition of cyclophosphamide, 5 replacement with cetirizine hydrochloride 2 or intravesical dimethyl sulphoxide (DMSO). 6 Some patients may develop irreversible obstruction despite pharmacological management. 5 In one review of 19 cases, seven (37%) required some form of surgical or radiological intervention.…”

Section: Discussionmentioning

confidence: 99%

Cystectomy for obstructive uropathy secondary to lupus cystitis: a learning point for urologists?

Siqueira

Mangera

Venugopal

et al. 2014

Journal of Clinical Urology

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A 72-year-old woman was referred to our service with a one-month history of painless, visible haematuria. There had been no concurrent symptoms of a lower urinary tract infection. She had a history of hypertension and took Simvastatin, Ramipril and Amitriptyline. She was independent and had no history of smoking or occupational exposure to carcinogens.A bladder mass identified at flexible cystoscopy obscured visualisation of the left ureteric orifice. Ultrasound examination identified left-sided hydroureteronephrosis. Magnetic resonance imaging (MRI) performed primarily to assess the bladder wall demonstrated 'diffuse thickening' (Figure). The left ureter was dilated to the level of the thickened vesico-ureteric junction with moderate left hydronephrosis. Rigid cystoscopy demonstrated a hyperaemic and haemorrhagic bladder mucosa. Histology from resectional biopsies revealed "florid, active chronic inflammation" with no evidence of neoplasia. Urine cytology was not analysed as this is not our usual practice.At follow-up, the patient's renal function had deteriorated (serum creatinine 273 µmol/l). A mercapto-acetyltriglycine (MAG-3) renogram demonstrated bilateral obstructive hydronephrosis. Insertion of ureteric stents was unsuccessful at repeat cystoscopy. Repeat biopsies showed benign inflammatory changes but because of deteriorating renal function secondary to obstructive uropathy, uncontrollable haematuria and ongoing concern regarding the possibility of bladder cancer, it was decided at a multi-disciplinary case conference that a cystectomy and ileal conduit formation (rather than a temporising nephrostomy or antegrade stent) would be the quickest solution to address these life-threatening problems. AbstractWe present the case of a 72-year-old woman with obstructive uropathy secondary to interstitial cystitis-like pathology as the presenting features of systemic lupus erythematosus (SLE). After her initial presentation with visible haematuria, she was shown to have hydroureteronephrosis and a bulky bladder mass. Histology of bladder biopsies demonstrated severe inflammation. Following unsuccessful attempts to stent the ureters, worsening renal function and a concern regarding possible malignancy, a cystectomy and ileal conduit were performed. Final histology showed her bladder had only benign inflammatory changes. Subsequent investigations led to a diagnosis of SLE. We suggest that in cases of obstructive uropathy in association with severe inflammation of the bladder, lupus cystitis should be considered at an early stage and managed with steroids in the first instance. This may lead to resolution of the underlying pathology and thus avoid the need for urinary diversion and cystectomy.

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“…Several unrelated nonstandard or adjunctive therapies for special situations exist: UVA‐1 ultraviolet phototherapy for cutaneous and systemic disease(162–166), an extensive list of therapies such as retinoids or thalidomide for recalcitrant cutaneous disease(23), dimethylsulfoxide (DMSO) for cystitis(167), lobenzarit or aminoglutethimide administration for systemic disease activity(168, 169), valproic acid/clonidine(170) or bromocriptine(171) treatment for lupus‐associated movement disorders, granulocyte–macrophage colony‐stimulating factor (GM‐CSF) therapy for recurrent infections(172), and administration of fresh frozen plasma (FFP) for complement‐deficient SLE patients(173). These reports (Table 4) provide some guidance for atypical and difficult cases as well as insight into the pathogenic mechanisms of this heterogeneous disease.…”

Section: Miscellaneous and Symptom‐specific Therapiesmentioning

confidence: 99%

Nonstandard and adjunctive medical therapies for systemic lupus erythematosus

McMurray

2001

Arthritis & Rheumatism

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Successful treatment of lupus erythematosus cystitis with DMSO

Cited by 12 publications

References 16 publications

Genitourinary complications of systemic lupus erythematosus

Genitourinary complications of systemic lupus erythematosus

Cystectomy for obstructive uropathy secondary to lupus cystitis: a learning point for urologists?

Nonstandard and adjunctive medical therapies for systemic lupus erythematosus

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