J Rheum Dis.  2014 Dec;21(6):336-339. 10.4078/jrd.2014.21.6.336.

Hemorrhagic Cystitis with Giant Cells in Rheumatoid Arthritis Treating with Tacrolimus

• Min IS
• Ju Y
• Kim HY
• Choi YJ
• Lee WS
• Yoo WH

• KMID: 2222941
• DOI: http://doi.org/10.4078/jrd.2014.21.6.336

Abstract

Hemorrhagic cystitis is a diffuse inflammation of the mucosa of the bladder, characterized by hematuria and burning upon urination. This might be caused by a variety of reasons, including undergoing chemotherapy (such as cyclophosphamide), radiation therapy, bladder cancer, certain viruses, urinary infections, and thrombocytopenia. There are no previous reports of hemorrhagic cystitis associated with the use of tacrolimus. This is the first case of hemorrhagic cystitis due to tacrolimus for the treatment of rheumatoid arthritis. We describe a case of hemorrhagic cystitis with giant cells in a patient with rheumatoid arthritis treating with tacrolimus. Hematuria resolved spontaneously with discontinuation of the drug.

Keyword

Hemorrhagic cystitis; Rheumatoid arthritis; Tacrolimus

MeSH Terms

Arthritis, Rheumatoid*
Burns
Cystitis*
Drug Therapy
Giant Cells*
Hematuria
Humans
Inflammation
Mucous Membrane
Tacrolimus*
Thrombocytopenia
Urinary Bladder
Urinary Bladder Neoplasms
Urination
Tacrolimus

Figure

• 

  Figure 1. Ground glass appearance of both lower lung fields on high-resolution CT of the lung (A). Cystoscopic examination of bladder showed erythematous mucosa (B) and atypical giant stromal cells in the lamina propria (arrows) showing enlarged, hyperchromatic, multilobulated nuclei were present on histological examination of cystoscopically biopsied bladder mucosal wall (C, H&E, ×200).

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