Bladder carcinoma in situ in a patient with Lupus cystitis

Abstract

Lupus cystitis is a well-known but rare complication of systemic lupus erythematosus. This manifestation is frequently associated with lupus enteritis. We report here a case of a 34-year-old man with lupus cystitis and enteritis who presented with diarrhea and bladder storage symptoms such as urinary frequency and nocturia. Serological tests showed positivity for anti-dsDNA, anti-SS-A and anti-SS-B antibodies. Enhanced computed tomography showed diffuse thickening and abnormal enhancement of bowel wall as well as right hydronephrosis. Cystoscopy revealed bladder trabeculation, a characteristic ribbed appearance, suggesting the presence of lupus cystitis. However, unexpectedly, a biopsy of randomly selected bladder tissue revealed bladder carcinoma in situ. Treatment with prednisolone (50 mg/day) improved abdominal symptoms, while the bladder irritation symptoms remained unchanged. After tapering the prednisolone dose to 20 mg/day, treatment of the bladder carcinoma in situ was started with intravesical Bacillus Calmette-Guèrin. To our knowledge, no reports of bladder cancer in association with lupus cystitis have been published to date. It is necessary to be aware of this serious complication when caring for patients with lupus cystitis.

Keywords:

• Bladder cancer
• cystoscopy
• lupus cystitis
• lupus enteritis
• systemic lupus erythematosus

Conflicts of interest

None.

Patient’s consent

We have had the written consent for the publication from the patient.