title: Severe interstitial cystitis associated with Sjögren's syndrome.
abstract: A 53-year-old woman presented with oliguria, urinary frequency, abdominal pain and severe edema of the lower extremities. Her serum creatinine was 8.1 mg/dl. Computed tomographic and ultrasonographic studies showed a severely dilated urinary bladder, and bilateral hydroureteronephrosis. Examination of a urinary bladder biopsy specimen showed subepithelial edema and infiltration by lymphocytes and plasmacytes. However, the patient complainted of dry mouth and dry eyes. Ophthalmologically, the Schirmer test was positive. A biopsy of the minor salivary glands in the lip showed chronic sialoadenitis. A diagnosis of Sjögren's syndrome complicated by interstitial cystitis was made. Since she had been anuric, secondary to urinary obstruction, intermittent self-catheterization was started. Combination of corticosteroid and cyclosporin therapy was initiated. Spontaneous urination began, and gradually the patient's symptoms remitted. After 8 months of therapy, bladder capacity increased from 140 ml to 350 ml, and she voided approximately 1,200 ml by herself and 600 ml by catheterization daily. This case suggests that when severe interstitial cystitis is associated with Sjögren's syndrome, a therapeutic trial of corticosteroids and cyclosporin may be beneficial.
authors.affiliation: Nephrology Center, Toranomon Hospital, Tokyo.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Shibata
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Ubara
authors.forename: Naoki
authors.initials: N
authors.lastname: Sawa
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Tagami
authors.forename: Junichi
authors.initials: J
authors.lastname: Hosino
authors.forename: Masafumi
authors.initials: M
authors.lastname: Yokota
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Katori
authors.forename: Fumi
authors.initials: F
authors.lastname: Takemoto
authors.forename: Shigeko
authors.initials: S
authors.lastname: Hara
authors.forename: Kenmei
authors.initials: K
authors.lastname: Takaichi
authors.forename: Akiko
authors.initials: A
authors.lastname: Fujii
authors.forename: Hirokatu
authors.initials: H
authors.lastname: Murata
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Nishi
mesh_terms: D016572:Cyclosporine / Q000627:therapeutic use; D018856:Cystitis, Interstitial / Q000150:complications*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D012470:Salivary Glands, Minor / Q000473:pathology; D012859:Sjogren's Syndrome / Q000150:complications*; D014057:Tomography, X-Ray Computed; D014546:Urinary Catheterization
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone