Cistitis enfisematosa: una complicación inesperada durante el tratamiento inmunosupresor en un paciente con poliangeítis microscópica  <span class="so-article-trans-title" dir="auto"> Translated title: Emphysematous cystitis: an unexpected complication of immunosuppressive therapy in a patient with Microscopic Polyangeiitis </span>

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Abstract

La cistitis enfisematosa es una rara condición caracterizada por la presencia de gas en el lumen y la pared de la vejiga como consecuencia de la colonización de microorganismos fermentadores. La mayoría de los casos se describen en mujeres de edad media con diabetes mellitus; es menos frecuente en pacientes inmunosuprimidos. A continuación presentamos un paciente con diagnóstico reciente de poliangeítis microscópica que desarrolló una cistitis enfisematosa como complicación del tratamiento inmunosupresor.

Translated abstract

Emphysematous cystitis is a rare condition characterized by the presence of gas in the bladder wall and lumen result of the colonization by fermentative microorganisms. Most of the cases have been described in middle-age woman suffering from Diabetes Mellitus, being less frequently in immunosuppressive patients. We report here a patient with Microscopic Poliangeiitis who developed emphysematous cystitis as a complication of immunosuppressive therapy.

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Outcomes from studies of antineutrophil cytoplasm antibody associated vasculitis: a systematic review by the European League Against Rheumatism systemic vasculitis task force.

D Jayne, O Flossmann, H Raspe … (2008)

We undertook a systematic literature review as a background to the European League Against Rheumatism (EULAR) recommendations for conducting clinical trials in anti-neutrophil cytoplasm antibody associated vasculitis (AAV), and to assess the quality of evidence for outcome measures in AAV. Using a systematic Medline search, we categorised the identified studies according to diagnoses. Factors affecting remission, relapse, renal function and overall survival were identified. A total of 44 papers were reviewed from 502 identified by our search criteria. There was considerable inconsistency in definitions of end points. Remission rates varied from 30% to 93% in Wegener granulomatosis (WG), 75% to 89% in microscopic polyangiitis (MPA) and 81% to 91% in Churg-Strauss syndrome (CSS). The 5-year survival for WG, MPA and CSS was 74-91%, 45-76% and 60-97%. Relapse (variably defined) was common in the first 2 years but the frequency varied: 18% to 60% in WG, 8% in MPA, and 35% in CSS. The rate of renal survival in WG varied from 23% at 15 months to 23% at 120 months. used to assess morbidity varied between studies. Ignoring the variations in definitions of the stage of disease, factors influencing remission, relapse, renal and overall survival included immunosuppressive therapy used, type of organ involvement, presence of ANCA, older age and male gender. Factors influencing remission, relapse, renal and overall survival include the type of immunosuppressive therapy used, pattern of organ involvement, presence of ANCA, older age and male gender. Methodological variations between studies highlight the need for a consensus on terminology and definitions for future conduct of clinical studies in AAV.

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Outcome of ANCA-associated renal vasculitis: a 5-year retrospective study.

, Peter Ellis, Martin Plaisance … (2003)

Renal involvement is frequently present in antineutrophil cytoplasmic autoantibody (ANCA)-associated systemic vasculitis and is an important cause of end-stage renal failure (ESRF). This retrospective, multicenter, sequential cohort study reports presenting features and outcome of 246 new patients diagnosed in London, UK, between 1995 and 2000. Diagnostic subgroups were microscopic polyangiitis, 120 patients (49%); Wegener's granulomatosis (WG), 82 patients (33%); renal-limited vasculitis, 33 patients (13.5%); and Churg-Strauss angiitis, 11 patients (4.5%). Median age was 66 years, 57% were men, and median creatinine level at presentation was 3.87 mg/dL (342 micromol/L). ANCA was present in 92%. Cumulative patient survival at 1 and 5 years was 82% and 76%, respectively. Mortality was associated with age older than 60 years (P < 0.001), development of ESRF (P < 0.001), initial creatinine level greater than 2.26 mg/dL (200 micromol/L; P = 0.01), and sepsis (P < 0.048). ESRF occurred in 68 patients (28%), of whom 47% died. Fifty-six patients who presented with a creatinine level greater than 5.65 mg/dL (500 micromol/L) survived, and 31 patients (55%) achieved dialysis independence. Relapse occurred in 34% after a median of 13 months and was more common in patients with WG (P = 0.048) and proteinase 3-ANCA (P = 0.034). Leukopenia occurred in 41% and was associated with sepsis (P < 0.001). Mortality and morbidity of ANCA-associated systemic vasculitis are improving compared with previous series, but remain high. Renal vasculitis often affects older patients, who have a particularly poor outcome. Early diagnosis improves outcome. Leukopenia, caused by immunosuppressive therapy, should be avoided because of the close association with sepsis and death.

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Prevalences of polyarteritis nodosa, microscopic polyangiitis, Wegener's granulomatosis, and Churg-Strauss syndrome in a French urban multiethnic population in 2000: a capture-recapture estimate.

C M Poissonnet, Ségolène Aymé, Alfred Mahr … (2004)

To estimate the prevalences of polyarteritis nodosa (PAN), microscopic polyangiitis (MPA), Wegener's granulomatosis (WG), and Churg-Strauss syndrome (CSS). Cases were collected in Seine-St. Denis County, a northeastern suburb of Paris, which has 1,093,515 adults (> or =15 years), 28% of whom are of non-European ancestry. The study period encompassed the entire calendar year 2000. Cases were identified by general practitioners, the departments of all the public hospitals and 2 large private clinics, and the National Health Insurance System. The Chapel Hill nomenclature was used to define MPA, and American College of Rheumatology criteria to define WG and CSS; PAN was diagnosed based on clinical laboratory, histological and/or angiographic findings. Three-source capture-recapture analysis was performed to correct for incomplete case ascertainment. A total of 75 cases were retained and capture-recapture analysis estimated that 23.8 cases had been missed by any 1 of the 3 sources. Accordingly, prevalences per 1,000,000 adults (95% confidence interval [95% CI]) were estimated to be 30.7 (95% CI 21-40) for PAN, 25.1 (95% CI 16-34) for MPA, 23.7 (95% CI 16-31) for WG, and 10.7 (95% CI 5-17) for CSS. The overall prevalence was 2.0 times higher for subjects of European ancestry than for non-Europeans (P = 0.01). This study provides the first prevalence estimates for these 4 vasculitides for a multiethnic, urban population. The significantly higher prevalence observed for Europeans may infer a genetic susceptibility of Caucasians. Compared with previous estimates based mostly on rural populations, the higher frequency of PAN and the lower frequency of WG might suggest specific environmental etiologic factors.

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Author and article information

Journal

Journal ID (publisher-id): rcre

Title: Revista Colombiana de Reumatología

Abbreviated Title: Rev.Colomb.Reumatol.

Publisher: Asociación Colombiana de Reumatología (Bogotá, Distrito Capital, Colombia )

ISSN (Print): 0121-8123

Publication date (Print and electronic): January 2011

Volume: 18

Issue: 1

Pages: 75-80

Affiliations

[03] Ciudad Autónoma de Buenos Aires orgnameHospital General de Agudos Juan A. Fernández orgdiv1Servicio de Anatomía Patológica Argentina

[02] orgnameServicio de Neurología

[01] orgnameServicio de Clínica Médica División A

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Publisher ID: S0121-81232011000100008 Publisher ID: S0121-8123(11)01800108

SO-VID: 1bbd49af-7333-4527-9c75-dfd1078649f7

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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Date accepted : 03 March 2011

Date received : 18 February 2011

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Figures: 0, Tables: 0, Equations: 0, References: 14, Pages: 6

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Cistitis enfisematosa: una complicación inesperada durante el tratamiento inmunosupresor en un paciente con poliangeítis microscópica Translated title: Emphysematous cystitis: an unexpected complication of immunosuppressive therapy in a patient with Microscopic Polyangeiitis

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SciELO Colombia

Most cited references 13

Outcomes from studies of antineutrophil cytoplasm antibody associated vasculitis: a systematic review by the European League Against Rheumatism systemic vasculitis task force.

Outcome of ANCA-associated renal vasculitis: a 5-year retrospective study.

Prevalences of polyarteritis nodosa, microscopic polyangiitis, Wegener's granulomatosis, and Churg-Strauss syndrome in a French urban multiethnic population in 2000: a capture-recapture estimate.

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