title: Sjögren's syndrome complicated by interstitial cystitis: A case series and literature review.
abstract: OBJECTIVE
  To characterize the interstitial cystitis (IC) associated with Sjögren's syndrome (SS).
  
  
  METHODS
  Report of three new cases. Only cases fulfilling the American-European consensus criteria for SS and the European Society for the Study of Interstitial Cystitis criteria with positive histological findings for IC were included.
  
  
  RESULTS
  Thirteen cases of SS and IC have been reported in women, including the three reported here, with a mean age of 54 years. SS appeared first in 77% (n=10) of cases, a mean of 6.6 years before IC. The symptoms of IC included pollakiuria (n=11), lower abdominal pain (n=8), urinary urgency (n=5), painful micturition (n=6), hematuria (n=3) and dysuria (n=3). Urinary dilatation occurred in three cases, leading to acute renal failure in two patients. The diagnosis of IC was confirmed by anatomical evidence of cystitis inflammation on bladder biopsy in all (n=13) patients. Treatment was reported for nine patients, seven of whom (78%) received corticosteroid treatment, which was partially or completely effective in six cases. Immunosuppressive treatment was added in three cases (cyclosporine, n=2; azathioprine, n=1; cyclophosphamide, n=1). Local bladder treatments were performed, with hydraulic distension in five cases and DMSO instillation in one patient. A urinary catheter was inserted in the two cases of acute obstructive renal failure.
  
  
  CONCLUSIONS
  Urinary symptoms without infection should lead the physician to consider a diagnosis of IC in SS patients. Urinary dilatation may occur, leading to acute obstructive renal failure. Corticosteroid treatment may be effective and local treatments have been tried.
authors: National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, hôpital Cochin, université Paris Descartes, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France; Department of Rheumatology, Nantes University Hospital, 44000 Nantes, France.
authors: Christelle
authors: C
authors: Darrieutort-Laffite
authors: Department of Rheumatology, Le Mans General Hospital, 72000 Le Mans, France.
authors: Vincent
authors: V
authors: André
authors: Department of Rheumatology, hôpital Bichat, Assistance publique-Hôpitaux de Paris, 75018 Paris, France.
authors: Gilles
authors: G
authors: Hayem
authors: Department of Rheumatology, hôpital de la Cavale Blanche, université de Brest, 29200 Brest, France.
authors: Alain
authors: A
authors: Saraux
authors: National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, hôpital Cochin, université Paris Descartes, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France.
authors: Véronique
authors: V
authors: Le Guern
authors: National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, hôpital Cochin, université Paris Descartes, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France.
authors: Claire
authors: C
authors: Le Jeunne
authors: National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, hôpital Cochin, université Paris Descartes, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France; Inserm U1016, CNRS UMR 8104, institut Cochin, 75014 Paris, France. Electronic address: xavier.puechal@cch.aphp.fr.
authors: Xavier
authors: X
authors: Puéchal
mesh_terms: D000328:Adult; D000368:Aged; D018856:Cystitis, Interstitial / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D003558:Cystoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008875:Middle Aged; D012859:Sjogren's Syndrome / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014057:Tomography, X-Ray Computed
chemical_list: D007166:Immunosuppressive Agents
keywords: Acute renal failure; Inflammatory cystitis; Sjögren's syndrome