Lupus Cystitis and Azathioprine-iIduced Pure Red Cell Aplasia in a Patient with Systemic Lupus Erythematosus |
Tai Yeon Koo1, Hyun Jung Kim1, Kyung Min Kim1, Dong Kyu Oh1, Geum Borae Park2 and Sang Koo Lee1 |
Department of Internal Medicine1 and Laboratory Medicine2 College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea |
증례 : 루푸스 방광염과 azathioprine에 의한 진성 적혈구 감소증이 병발된 전신성 홍반성 루푸스 1예 |
구태연1, 김현정1, 김경민1, 오동규1, 박금보래2, 이상구1 |
울산대학교 의과대학 서울아산병원 내과학교실1, 진단검사의학교실2 |
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Abstract |
We report a case of lupus cystitis as the manifestation of lupus flare, and pure red cell aplasia resulting from the use of azathioprine in a patient with systemic lupus erythematosus (SLE). A 30-year-old female with a nine-year history of SLE was admitted to our hospital with complaint of anemia and azotemia. Eighteen and three months before, she had two episodes of lupus enteritis treated with high dose steroid. She had serologic evidence of an SLE flare at admission. Abdominal computed tomography revealed bilateral hydronephrosis and hydroureter with marked diffuse thickening of the urinary bladder wall, suggesting lupus cystitis. Treatment with corticosteroid led to prompt normalization of her renal function. Use of azathioprine may lead to severe anemia. The bone marrow examination revealed a decrease of erythropoiesis, suggesting pure red cell aplasia. Serologic tests for hepatitis B and parvovirus B19 were negative. There was immediate hemoglobin recovery after complete azathioprine discontinuation. |
Key Words:
Systemic lupus erythematosus, Cystitis, Azathioprine, Anemia, Pure red cell aplasia |
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