HEMORRHAGIC CYSTITIS COMPLICATING UNTREATED NECROTIZING VASCULITIS

Although the genitourinary system is frequently affected in potyarteri tis nodosa, involvement of the walt of the urinary bladder is extremel y uncommon; moreover, when reported, it has been merely as an incident al finding tate in the disease course. In contrast, hemorrhagic cystit is is a well-recognized complication of cyclophosphamide therapy for t he systemic vasculitides, but has not previously been reported to comp licate untreated vasculitis. Herein is described a patient who present ed with non-treatment-related hemorrhagic cystitis which was found to be due to nongranulomatous necrotizing vasculitis of the wall of the u rinary bladder. This represents both a novel presentation of polyarter itis and a previously unreported etiology of hemorrhagic cystitis. The differential diagnosis of apparently spontaneous hemorrhagic cystitis should therefore include active necrotizing vasculitis, independent o f prior therapy.