Korean Journal of Nephrology  2011;30(1):102-106

Lupus Cystitis and Azathioprine-iIduced Pure Red Cell Aplasia in a Patient with Systemic Lupus Erythematosus.

Tai Yeon KOO 1 ; Hyun Jung KIM ; Kyung Min KIM ; Dong Kyu OH ; Geum Borae PARK ; Sang Koo LEE

Affiliations

+expand

Keywords

Systemic lupus erythematosus; Cystitis; Azathioprine; Anemia; Pure red cell aplasia

Country

Republic of Korea

Language

Korean

Abstract

We report a case of lupus cystitis as the manifestation of lupus flare, and pure red cell aplasia resulting from the use of azathioprine in a patient with systemic lupus erythematosus (SLE). A 30-year-old female with a nine-year history of SLE was admitted to our hospital with complaint of anemia and azotemia. Eighteen and three months before, she had two episodes of lupus enteritis treated with high dose steroid. She had serologic evidence of an SLE flare at admission. Abdominal computed tomography revealed bilateral hydronephrosis and hydroureter with marked diffuse thickening of the urinary bladder wall, suggesting lupus cystitis. Treatment with corticosteroid led to prompt normalization of her renal function. Use of azathioprine may lead to severe anemia. The bone marrow examination revealed a decrease of erythropoiesis, suggesting pure red cell aplasia. Serologic tests for hepatitis B and parvovirus B19 were negative. There was immediate hemoglobin recovery after complete azathioprine discontinuation.