Case Reports in Rheumatology

Case Series

Very Severe and Refractory Noninfectious Cystitis in Patients with Systemic Lupus Erythematosus: Potential Role of Rituximab Therapy

Table 1

The clinical manifestations and treatment of SLE before the onset of VSRC, the clinical and paraclinical manifestations of VSRC, the treatments received, and the final outcome.


Case	Age at diagnosis of SLE (years)	Main manifestations of SLE	Treatments for inducing SLE remission	Maintenance treatment for SLE	Age at onset of VSRC (years)	SLEDAI 2 K at VSRC onset	Manifestations of VSRC	Treatments for VSRC with failed response	VSRC outcome, relationship with SLE activity

1	40	Mucocutaneous Musculoskeletal Cardiovascular (endocarditis) Immunological	Glucocorticoids Azathioprine Mycophenolate Mofetil Rituximab	Rituximab (3 cycles)	44	1	Dysuria Polyuria Nocturia	Methylprednisolone Azathioprine Fexofenadine Amitriptyline	Improvement, SLE inactive

2	14	Musculoskeletal Renal Pulmonary Haematologic Immunological	Glucocorticoids Mycophenolate Mofetil Cyclophosphamide Rituximab	Rituximab (6 cycles)	21	2	Dysuria Polyuria Nocturia Perineal pain Bladder pressure	Prednisolone Amitriptyline Hydroxyzine Oxybutynin Carbamazepine Gabapentin Botulinum toxin	Improvement, SLE inactive

3	19	Renal Musculoskeletal Haematologic Immunological	Glucocorticoids Mycophenolate Mofetil Cyclophosphamide	Mycophenolate Hydroxychloroquine Rituximab started at relapse (one cycle)	23	8	Dysuria Polyuria Severe perineal pain Bladder pressure Hypogastric pain	Methylprednisolone Amitriptyline Anti-H1 Anti-H2 : ranitidine NSAIDs Opioids Pregabalin Hyoscine bromide Intravenous gamma globulin Pudendal block Urethral infiltration (partial response)	Refractoriness to treatment, SLE inactive

4	12	Renal Haematologic Immunological Mucocutaneous Neurological Gastrointestinal	Glucocorticoids Azathioprine Mycophenolate Mofetil Cyclophosphamide Rituximab	Rituximab (7 cycles)	20	12	Dysuria Polyuria Nocturia	Methylprednisolone IV Instillations (heparin and lidocaine) Oxybutynin Montelukast	Refractory treatment, relapse of SLE. Death associated with infections, multisystem failure.