SYSTEMIC LUPUS-ERYTHEMATOSUS RELAPSE WITH LUPUS CYSTITIS

A 45-year-old woman who had been diagnosed as having systemic lupus er ythematosus (SLE) at the age of 28 years and who had been in remission developed severe urinary frequency, watery diarrhea, vomiting and wei ght loss. She also developed acute renal failure and her serological e xamination was consistent with active SLE. She had a markedly decrease d urinary bladder capacity of 20 mi with hydroureteronephrosis. Histop athological study of her urinary bladder biopsy specimen showed mucosa l edema, infiltration by lymphocytes and granulocytes, and deposition of IgA in the epithelium and submucosal region. We diagnosed this as a case of lupus cystitis. The patient's symptoms were alleviated by bil ateral nephrostomy and corticosteroid therapy. In the present episode the patient showed none of the usual symptoms of SLE. This case and ot hers reported in the literature show that lupus cystitis presents with specific signs and symptoms and therefore, this syndrome may represen t a specific clinical manifestation of SLE.