Urinary Bladder Complications With Cyclophosphamide Therapy

The use of cytotoxic drugs in rheumatic diseases is attended by many potential side-effects, including infection, bone marrow depression, gastrointestinal toxic reactions, infertility, teratogenesis, and neoplasia.¹In addition, individual drugs have rather specific side-effects. The urinary bladder complications that have been reported with the use of cyclophosphamide include acute hemorrhagic cystitis, chronic cystitis, urine cytologic abnormalities, mucosal telangiectasia, interstitial fibrosis, and transitional cell carcinoma.²We report the occurrence of severe and prolonged hemorrhagic cystitis, bladder calculi, and eosinophilic cystitis in a patient with systemic lupus erythematosus (SLE) who was treated with cyclophosphamide.

PATIENT SUMMARY

An 18-year-old man was admitted to a neighboring hospital with acute psychosis, epilepsy, and pericarditis in November 1968. The result of an antinuclear factor (ANF) test was reported to be positive. A diagnosis of SLE with cerebral vasculitis was made, and the patient was treated with corticotropin and cyclophosphamide, intravenously. During the next ten