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Lupus Cystitis Can Point to More Severe Lupus; Intensive Follow-Up Recommended

Koh JH, Lee J, Jung SM, Ju JH, Park SH, Kim HY, Kwok SK. Lupus cystitis in Korean patients with systemic lupus erythematosus: risk factors and clinical outcomes. Lupus. 2015 Jun 1. pii: 0961203315588575. [Epub ahead of print]

The goal of this study was to get more information on the clinical characteristics, risk factors, and clinical outcomes of lupus cystitis in Korean patients with systemic lupus erythematosus (SLE). Investigators reviewed the records of patients seen between 1998 and 2013, and identified 24 patients with lupus cystitis, including 2 patients who died of urinary tract infections. Compared with a group of 65 patients with SLE only (i.e., no lupus cystitis), patients with lupus cystitis had a significantly lower level of C3 (low levels of C3 point to active lupus). The patients with lupus cystitis also had higher disease activity, along with higher ESR (high levels of ESR suggest active lupus). Moreover, patients with lupus cystitis more often had a pre-admission history of lupus mesenteric vasculitis (LMV), a condition that causes acute abdominal pain. About one-third of patients with lupus cystitis developed complications. Based on these findings, investigators recommend considering a diagnosis of lupus cystitis when patients with SLE and a history of LMV present with symptoms of the lower urinary tract or gastrointestinal tract. They also recommend intensive treatment and follow-up, particularly for patients with complications, since those complications can potentially be fatal.