Formalin treatment of refractory hemorrhagic cystitis in systemic lupus erythematosus

Hemorrhagic cystitis is a potentially life-threatening complication in syst emic lupus erythematosus (SLE). No safe, effective and conservative treatme nt exists for patients who fail to respond to standard therapy. We report a 17-year-old girl with SLE who suffered from severe hemorrhagic cystitis. I nitially, she received frequent red blood cell and platelet transfusions, c ontinuous bladder irrigation, and blood clots were evacuated. Numerous kind s of treatment were tried, including electrocoagulation of bleeding foci, p rostaglandin E-1 bladder instillation, and hyperbaric oxygen. However, she remained severely anemic and thrombocytopenic necessitating daily transfusi ons of blood products. After intravesical formalin instillation was perform ed twice, the hematuria ceased completely.