Nishizaki Yuji, Tamaki Hiromichi, Yukawa Sonosuke, Matsui Yukio, Okada Masato
Section of Allergy and Rheumatology, Department of Internal Medicine, St. Luke's International Hospital, Japan.
Intern Med. 2011;50(9):961-8. doi: 10.2169/internalmedicine.50.4708. Epub 2011 May 1.
This study was carried out to determine the characteristics of lupus cystitis and to compare those of Japanese cases with those of non-Japanese cases. We also report a novel therapy for lupus cystitis refractory to corticosteroid.
For the literature search, published reports on lupus cystitis were searched by MEDLINE and ICHUSHI WEB. The inclusion criterion was interstitial cystitis, fulfilling the SLE classification criteria of American College of Rheumatology in 1997 and with either hydronephrosis detected by image studies (either computed tomography or ultrasonography) or bladder histopathology consistent with lupus cystitis. Interstitial cystitis without the fulfillment of the classification criteria was excluded. Patient demographic data and clinical data were retrieved from the literature and analyzed.
Including the present 2 cases, a total of 78 cases were identified as definitive cases of lupus cystitis (35 non-Japanese cases and 43 Japanese cases). Female patients accounted for 90.7%. The preceding gastrointestinal symptoms and subsequent urinary symptoms were the most frequent. Anti-double strand DNA antibody most often expressed in the 76.1% of the patients. Mean age and the prevalence of vomiting were significantly higher among Japanese patients compared to non-Japanese cases and the prevalence of CNS involvement was lower among Japanese patients (p=0.03, 0.04 and 0.001). We report a novel therapy (cetirizine hydrochloride) for lupus cystitis refractory to corticosteroid in one of the present cases.
Lupus enteritis, female gender, and positive anti-dsDNA antibody are risk factors for lupus cystitis. Japanese cases showed older age, a higher prevalence of vomiting and a lower prevalence of CNS involvement. We also report the efficacy of the novel use of cetirizine hydrochloride for lupus cystitis refractory to corticosteroid.
本研究旨在确定狼疮性膀胱炎的特征，并比较日本患者与非日本患者的情况。我们还报告了一种针对对皮质类固醇难治的狼疮性膀胱炎的新疗法。
为进行文献检索，通过医学文献数据库（MEDLINE）和日本医学中央杂志数据库（ICHUSHI WEB）搜索关于狼疮性膀胱炎的已发表报告。纳入标准为间质性膀胱炎，符合1997年美国风湿病学会的系统性红斑狼疮分类标准，且影像学检查（计算机断层扫描或超声检查）发现肾积水或膀胱组织病理学与狼疮性膀胱炎一致。不符合分类标准的间质性膀胱炎被排除。从文献中检索患者人口统计学数据和临床数据并进行分析。
包括本研究中的2例患者，共确定78例为狼疮性膀胱炎确诊病例（35例非日本患者和43例日本患者）。女性患者占90.7%。最常见的前驱症状是胃肠道症状，随后是泌尿系统症状。76.1%的患者最常出现抗双链DNA抗体。与非日本患者相比，日本患者的平均年龄和呕吐发生率显著更高，而日本患者中枢神经系统受累的发生率更低（p = 0.03、0.04和0.001）。我们报告了本研究中的1例患者使用一种新疗法（盐酸西替利嗪）治疗对皮质类固醇难治的狼疮性膀胱炎。
狼疮性肠炎、女性性别和抗双链DNA抗体阳性是狼疮性膀胱炎的危险因素。日本患者年龄较大，呕吐发生率较高，中枢神经系统受累发生率较低。我们还报告了盐酸西替利嗪新用途对皮质类固醇难治的狼疮性膀胱炎的疗效。
