Sj gren s Syndrome Complicated with Interstitial Cystitis 3 Cases Reports with Literature Review

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1 CHINESE JOURNAL OF ALLERGY & CLINICAL IMMUNOLOGY 3 * ** # Sj gren s syndromess interstitial cystitisic 3 SS IC 3 2 SS IC 3 2 SS IC SS IC R DOI j. issn A Sj gren s Syndrome Complicated with Interstitial Cystitis 3 Cases Reports with Literature Review LI Zun-zhong * LI Meng-taoZENG Xue-jun ** XU DongHOU Yong # ZENG Xiao-fengZHANG Feng-chun Department of RheumatologyPeking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeKey Laboratory of Rheumatology and Clinical ImmunologyMinistry of EducationBeijing China Objective To analyze the clinical features of Sj gren s syndrome SS complicated with Interstitial cystitis IC. Methods Three patients of SS complicated with IC admitted to PUMCH were retrospectively analyzed. Results Three patients were all female. All patients complained of urinary frequencyurgency and suprapubic pain. Before the diagnosis of IC was definedall patients were misdiagnosed as infective diseases. The initial symptoms of 2 patients of SS were IC symptoms. Treatments such as glucocorticsteroid and immunosuppressive agentscould relieve the symptom in about 2 weeks later. Conclusions Patients of SS complicated with IC primarily manifest with urinary frequency and urgency. It s easy to be misdiagnosed as urinary tract infection. In order to be treated earlyic should be considered when patients with SS complain of recurrent urinary discomfort. Key words Sj gren s syndrome interstitial cystitis Chin J Allergy Clin Immunol * ** # houyongjia@ hotmail. com 138 June2014

2 3 Sj gren s syndromess urnp IgG ~ g L C3 C4 CH50 erythrocyte SS sedimentation rateesr 40 mm 1h24 h g L interstitial cystitisic ml min 3 SS IC ENA SSA + SSB + SS IC SS IC LESR 52 mm 1hIgG g LIgA g L ANA SN dsdna ENA 2 SSA SSB Hunner 3 30 mg d ESR IgG SS IC mg d 2 2cm 3cm 5 mg d g d anti-nuclear antibodyana HS ~ DNA double- stranded DNAdsDNA 3 extractable nuclear antigenena SSA 1 64 SS 40 mg d ml g L μl g L 25 μl ml 100 ml + SSB Sm Vol. 8 No

3 2 1 IC 3 IC bladder pain syndrome 2 ~ 4 5 BPS 6 ~ 19 5HP ~ IC 1 50 IC ~ ml 2. 3 IC LESR 38 mm 1h 80 μl IgG g LIgA g L U mlana H1 640 SSA SSB SSIC 55 mg d 50 mg d 0. 2 g d 1 SS IC 8 60% IC Hunner 6 38 ~ 58 IC 9 IC SS SS IC ~ 58 IC SS SS IC 0 ~ 11 3 SS IC SS IC SS 3 SS IC 5 SS SS Table 1 1 SS IC Cases data of Sj gren s syndrome complicated with interstitial cystitis IC IC SS CS CS CSCTX 40 1 CS CS CTX 44 1 CSCTX SS IC CTX CS 140 June2014

4 3 SS IC SS IC SS IC Shibata CT 1 Vitali CBombardieri S Jonsson Ret al. Classification European criteria proposed by the American-European SS IC 6 Consensus Group J. Ann Rheum Dis Orth IC Gillenwater JYWein AJ. Summary of the National Institute of ArthritisDiabetesDigestive and Kidney Diseases Workshop on Interstitial Cystitis J. J Urol Homma YUeda TTomoe Het al. Clinical guidelines 2 for interstitial cystitis and hypersensitive bladder syndrome. Int J Urol J Shibata 11 SS IC J. SLE IC IC J SS criteria for Sj gren s syndrome a revised version of the Curhan GCSpeizer FEHunter DJet al. Epidemiology of interstitial cystitis a population based IC study J. J Urol ~ 50 mg d J Van de Merwe JP. Interstitial cystitis and systemic 1 ~ 1. 5 mg kg - 1 d - 1 autoimmune disease J. Nat Clin Pract Urol IC Van de Merwe JPYamada TSakamoto Y. Systemic aspects of interstitial cystitisimmunology and linkage with autoimmune disorders. Int J Urol IC Suppl S Shibata SUbara YSawa Net al. Severe interstitial cystitis associated with Sj gren s syndrome J. Intern Med Orth RWWeisman MHCohen AHet al. Lupus IC cystitis primary bladder manifestations of systemic SS 6 lupus erythematosus J. Ann Intern Med Vol. 8 No

5 Kornu ROliver QZReimold AM. Recognizing concomitant lupus enteritis and lupus cystitis J. J Clin Rheumatol Shimizu ATamura ATago Oet al. Lupus cystitis a case report and review of the literature J. Lupus Nickel JCBarkin JForrest Jet al. Elmiron Study Group. Randomizeddouble-blinddose-ranging study of pentosan polysulfate sodium for interstitial cystitis J. Urology Emmungil HKalfa MZihni FYet al. Interstitial cystitis a rare manifestation of primary Sj gren s syndromesuccessfully treated with low dose cyclosporine J. Rheumatol Int June2014

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