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3/1/06
DMSO AND LUPUS ERYTHEMATOSUS CYSTITIS

Systemic Lupus Erythematosus (SLE) is an autoimmune disease entity with multi-organ involvement.

In an article authored by Jose R. Sotolongo, Jr., M.D.; Frederick Swerdlow, M.D.; Howard I. Schiff, M.D.; and Hans E. Schapira, M.D., it is reported that "Systemic Lupus Erythematosus patients sometimes present with pathologically confirmed lupus interstitial cystitis. Treatment with prednisone has not been observed to be successful."

The doctors cite two case studies of patients who were successfully treated with DMSO. Case #1 involved a forty-six year-old white woman with well-documented systemic lupus erythematosus who presented with symptoms of dysuria, urinary frequency, and suprapubic pain, as well as a malar rash over her arms and legs on exposure to the sun, fatigue, malaise, high fevers, and arthralgias. She had responded well to treatment with prednisone. A biopsy taken confirmed the diagnosis of interstitial cystitis. Fifty cc of a 50 percent solution of DMSO was instilled intravesically on three occasions at monthly intervals. The patient's symptoms abated and had not reoccurred in fifteen months.

Case #2 involved a thirty-one year-old white woman with a fifteen-year history of documented SLE. She was admitted to the hospital with a high grade fever, arthralgias, and a skin abscess of the thigh. She had been on steroids for many years. The patient also had a history of COPD (chronic obstructive pulmonary disease) secondary to pulmonary interstitial fibrosis, arteriosclerotic heart disease manifested as angina pectoris (a paroxysmal thoracic pain, often radiating to the arms, particularly to the left), and seizure disorders.

At the time of a prior admission, the patient had complained of dysuria, urinary frequency, and occasional suprapubic discomfort. The patient was subsequently diagnosed with interstitial cystitis and treated with instillation of hydrocortisone (Solu-Cortef) without positive results. Thus, 50 cc of a 50 percent solution of DMSO was instilled in the bladder and retained for one hour. The patient experienced a reduction in symptoms, however, continued to experience dysuria and urinary frequency. Instillations of DMSO were repeated at monthly intervals for two months, then every six months thereafter for five more doses with marked improvement with each administration of DMSO. The patient remained totally asymptomatic three years after the last instillation of DMSO.

The authors of this article concluded: "Interstitial cystitis in association with systemic lupus erythematosus has been observed in selected lupus patients. Although the exact association of cystitis and lupus is as yet undefined, there is evidence suggesting that the cystitis may be a manifestation of the collagen disease. Previously treated with systemic steroids with uneven and generally unsatisfactory results, lupus cystitis responded dramatically to intravesical DMSO in the two cases presented."




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