Asia S, Martellotto G, Belén R, Sesín A Maria, Gamróm S, Drenkard C
Division of Nephrology, Department of Internal Medicine, Universidad Nacional de Cordoba, Hospital Nacional de Clinicas, Cordoba, Argentina.
Lupus. 2008 Jan;17(1):46-9. doi: 10.1177/0961203307084711.
Chronic interstitial cystitis and ureteral stenosis has occasionally been reported in systemic lupus erythematosus, mostly associated with gastrointestinal symptoms. We report a case of obstructive uropathy associated to chronic interstitial cystitis as the only manifestation of lupus flare in a patient with SLE and anti-phospholipid syndrome (APS) who had been in remission for many years. The development of chronic interstitial cystitis in patients with SLE and APS has not been previously reported. Histopathological study of her urinary bladder and ureteral meatus showed chronic inflammatory infiltrate in the subepithelium. Lack of significant lower urinary tract symptoms and gastrointestinal involvement were some of the factors that could have prevented an earlier diagnosis. Obstructive uropathy and renal insufficiency initially improved with immunosuppressive treatment and endoureteral protheses, but poor compliance to the therapy led to ominous ending.
慢性间质性膀胱炎和输尿管狭窄在系统性红斑狼疮中偶尔有报道，大多与胃肠道症状相关。我们报告一例梗阻性尿路病合并慢性间质性膀胱炎的病例，这是一名患有系统性红斑狼疮和抗磷脂综合征（APS）且已缓解多年的患者狼疮发作的唯一表现。系统性红斑狼疮和抗磷脂综合征患者发生慢性间质性膀胱炎此前尚未见报道。对其膀胱和尿道口的组织病理学研究显示上皮下有慢性炎性浸润。缺乏明显的下尿路症状和胃肠道受累是可能导致早期诊断延误的部分因素。梗阻性尿路病和肾功能不全最初经免疫抑制治疗和输尿管内支架置入后有所改善，但患者对治疗依从性差导致了不良结局。
