Urinary bladder involvement in patients with systemic lupus erythematosus with review of the literature.
- Author:
Jun Ki MIN
1
;
Jae Young BYUN
;
Sang Heon LEE
;
Yeon Sik HONG
;
Sung Hwan PARK
;
Chul Soo CHO
;
Ho Youn KIM
Author Information
1. Holy Family Hospital, Department of Internal Medicine, College of Medicine, Catholic University of Korea, Kyunggi-Do, Korea.
- Publication Type:Original Article ; Review
- Keywords:
systemic lupus erythematosus;
urinary bladder involvement;
gastrointestinal tract involvement
- MeSH:
Adolescence;
Adult;
Cystitis/radiography;
Cystitis/etiology+ACo-;
Cystitis/epidemiology;
Female;
Gastrointestinal Diseases/radiography;
Gastrointestinal Diseases/etiology+ACo-;
Gastrointestinal Diseases/epidemiology;
Human;
Lupus Erythematosus, Systemic/diagnosis;
Lupus Erythematosus, Systemic/complications+ACo-;
Male;
Middle Age;
Prevalence;
Prognosis;
Retrospective Studies;
Risk Assessment;
Tomography, X-Ray Computed
- From:The Korean Journal of Internal Medicine
2000;15(1):42-50
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVES: To investigate the etiologies of urinary bladder involvement in patients with systemic lupus erythematosus (SLE), the clinicoradiologic features of gastrointestinal tract manifestations and clinical outcomes in patients with lupus cystitis accompanied by gastrointestinal manifestations. METHODS: We conducted a retrospective chart review on 413 patients with SLE. Patients were selected for review on the basis of lower urinary tract symptoms including urinary frequency, urgency and urinary incontinence. Radiologic studies were analyzed in patients with lupus cystitis. RESULTS: Ten consecutive patients, complicated with lower urinary tract symptoms, were identified. Underlying etiologies were as follows: lupus cystitis in five, neurogenic dysfunction secondary to transverse myelitis in three, cyclophosphamide-induced cystitis in one and tuberculous cystitis in one patient. All patients with lupus cystitis showed gastrointestinal manifestations, such as abdominal pain, nausea, vomiting and/or diarrhea during the periods of cystitis symptoms. In all patients with lupus cystitis, paralytic ileus was demonstrated on plain abdominal X-ray and ascites, bilateral hydroureteronephrosis and thickened bladder wall were identified on abdominal ultrasound or CT. Abdominal CT revealed bowel wall thickening in four of the five patients. The main sites of thickened bowel on abdominal CT were territory supplied by superior mesenteric artery. Two of five patients with lupus cystitis expired during the follow-up period. CONCLUSION: Diverse etiologies may cause lower urinary tract symptoms in patients with SLE. Lupus cystitis is strongly associated with gastrointestinal involvement and abdominal CT can be a useful radiologic tool to investigate the gastrointestinal tract involvement in patients with lupus cystitis.
