プレドニゾロンが有効であったシェーグレン症候群に合併した間質性膀胱炎

Therapeutic efficacy of prednisolone for interstitial cystitis accompanying Sjögren syndrome：A case report

　頻尿，蓄尿痛が主訴の79歳女性。膀胱腫瘍を疑い施行した膀胱鏡で悪性所見なく，間質性膀胱炎を疑うさみだれ状の出血を認めた。臨床症状と併せて間質性膀胱炎と診断。経過中に口内乾燥と霧視の訴えあり，眼科および耳鼻科でシェーグレン症候群と診断された。尿路症状に対してはトシル酸スプラタストを投与していたが急性疼痛が出現し，膀胱水圧拡張術を施行するが効果なく，プレドニゾロン投与にて疼痛および頻尿の改善を認めた。シェーグレン症候群に合併する間質性膀胱炎の難治性の下部尿路症状に対して，プレドニゾロンは試みる価値があると思われる。

　A 79-year-old woman visited our hospital with complains of bladder pain and urinary frequency. For suspected bladder malignancy,we performed cystoscopy and bladder biopsy under spinal anesthesia. However,mucosal hemorrhage consistent with interstitial cystitis developed after bladder distention and pathological finding was interstitial infiltration of inflammatory cell. We used suplatast tosilate for treating interstitial cystitis. She also had dry mouth and blurred vision and was subsequently diagnosed as Sjögren syndrome. We started prednisolone to treat her lower urinary tract symptoms because her symptoms were refractory to bladder hydrodistention and suplatast tosilate. Her symptoms improved markedly by the treatment of prednisolone. For patients with interstitial cystitis accompanying Sjögren syndrome,we recommen the use of prednisolone to manage lower urinary tract symptoms refractory to hydrodistention and other medication.