루푸스 방광염과 azathioprine에 의한 진성 적혈구 감소증이 병발된 전신성 홍반성 루푸스 1예

• Published in: Kidney research and clinical practice Vol. 30; no. 1; pp. 102 - 106
• Main Authors: 구태연, Tai Yeon Koo, 김현정, Hyun Jung Kim, 김경민, Kyung Min Kim, 오동규, Dong Kyu Oh, 박금보래, Geum Borae Park, 이상구, Sang Koo Lee
• Format: Journal Article
• Language: Korean
• Published: 대한신장학회 30.01.2011
• Subjects: Anemia; Azathioprine; Cystitis; Pure red cell aplasia; Systemic Lupus erythematosus; 내과학
• ISSN: 2211-9132; 2211-9140

We report a case of lupus cystitis as the manifestation of lupus flare, and pure red cell aplasia resulting from the use of azathioprine in a patient with systemic lupus erythematosus (SLE). A 30-year-old female with a nine-year history of SLE was admitted to our hospital with complaint of anemia and azotemia. Eighteen and three months before, she had two episodes of lupus enteritis treated with high dose steroid. She had serologic evidence of an SLE flare at admission. Abdominal computed tomography revealed bilateral hydronephrosis and hydroureter with marked diffuse thickening of the urinary bladder wall, suggesting lupus cystitis. Treatment with corticosteroid led to prompt normalization of her renal function. Use of azathioprine may lead to severe anemia. The bone marrow examination revealed a decrease of erythropoiesis, suggesting pure red cell aplasia. Serologic tests for hepatitis B and parvovirus B19 were negative. There was immediate hemoglobin recovery after complete azathioprine discontinuation.