Hong Kong Journal of Nephrology

Volume 4 Number 2, 2002

Obstructive uropathy in two Chinese patients with lupus interstitial cystitis

Wai-Leung CHAK, Kim-Ming WONG, Philip Chor-Her KWOK, Koon-Shing CHOI, Yiu-Hang CHAN, Chi-Yuen CHEUNG, Ka-Foon CHAU, Chun-Sang LI

We report herein two patients who presented with bilateral hydronephrosis attributed to lupus cystitis with two totally different clinical consequences. Both had systemic lupus erythematosus complicated with nephritis and nephrotic range of proteinuria. During the investigation of their proteinuria, they were noted to have a dilated collecting system. The site of obstruction was localized at the vesicoureteric obstruction by excretory urogram. The hydronephrosis resolved spontaneously in one patient before the commencement of any medical therapy, whereas in the other patient, there was no response to steroid therapy. Augmentation enterocystoplasty was thus performed. Reversible hydronephrosis caused by vesicoureteric junction obstruction in patients with systemic lupus erythematosus has been reported. Immune-mediated vasculitis involving the ureter and bladder mucosa was the postulated pathogenic mechanism. The condition usually showed good clinical response upon immunosuppressive therapy. We conclude that systemic lupus erythematosus-associated interstitial cystitis can have a spectrum of different prognoses. (Hong Kong J Nephrol 2002;4(2):101-104)

Key words: Bladder/pathology, Cystitis/complications, Immunosuppressive agents/therapeutic use, Lupus erythematosus, Systemic/pathology

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