Ogawa Hirohisa, Nakamura Yoichi, Tokinaga Kenji, Sakakura Naoki, Yamashita Motoyuki
Dept. of Clinical Research, National Kochi Hospital.
Arerugi. 2005 Jul;54(7):641-5.
A case is a 62 years old woman who consulted her family physicion with pollakiuria and sharp pain at the time of urinary bladder distention. Since anti-H1-antagonist but not antibiotics was partially effective against the symptoms and some specific food ingestion appeared to increase the bladder pain, she was referred to our hospital. Treatment with spulatast tosilate and elimination of food products that revealed the presence of specific IgE antibodies and positive skin reactiont resulted favorable clinical response. Cystoscopic examination showed reduction in bladder capacity, mucosal injection and vascularization, besides pinpoint submucosal hemorrage and linear ulcer by hydrodistension. The diagnosis of interstitial cystitis was established by those evidences and histological findings. The patient got apparent remission after the bladder hydrodistension and is now in steady state with an addition of suplatast tosilate, a Th2 cytokine inhibitor, on the treatment mentioned above. Interstitial cystitis is a very rare disease which is characterized by cystitis-symptoms with normal urinary finding and non-effectiveness of antibiotics. The pathogenesis of the disease is unclear but considered as allergic inflammation. We report a case of interstitial cystitis accompanied by food allergy.
病例为一名62岁女性，因尿频及膀胱充盈时剧痛就诊于家庭医生。由于抗H1拮抗剂而非抗生素对症状有部分疗效，且某些特定食物摄入似乎会加重膀胱疼痛，她被转诊至我院。使用托西酸舒他西林治疗并排除显示存在特异性IgE抗体和皮肤反应阳性的食品后，临床反应良好。膀胱镜检查显示膀胱容量减小、黏膜充血和血管增生，此外还有水扩张引起的黏膜下点状出血和线状溃疡。根据这些证据和组织学检查结果确诊为间质性膀胱炎。患者在膀胱水扩张后明显缓解，目前在上述治疗基础上加用Th2细胞因子抑制剂托西酸舒他西林，病情稳定。间质性膀胱炎是一种非常罕见的疾病，其特征为膀胱炎症状、尿液检查正常且抗生素无效。该病的发病机制尚不清楚，但被认为是过敏性炎症。我们报告一例伴有食物过敏的间质性膀胱炎病例。
