限局性尿管・膀胱アミロイドーシスに対するDimethyl sulfoxide(DMSO)の経皮的吸収療法が奏効した1例

Abstract

症例は48歳女で, 患者にはDMSOによる密封包帯療法(連日就寝前に50%DMSO溶液約7mlをガーゼに浸して大腿に貼付し, その上からラップで約60分間覆う方法)を指導し, これを継続させた.本法の施行中, 皮膚の軽い発赤や掻痒感の訴えがあったものの治療を中止するほどではなく, 良好な経過が得られた

We report here the first case of localized amyloidosis of the ureter and bladder to be treated effectively by occlusive dressing technique therapy using dimethyl sulfoxide. The patient was a 48-year-old woman whose chief complaint was macrohematuria and right back pain. Ultrasound sonography demonstrated right hydronephrosis and an intravesical mass in the region of the right ureteral orifice. Retrograde pyelography revealed severe stricture of the right lower ureter. Cystoscopy demonstrated a yellow submucosal tumor around the right ureteral orifice. We suspected urinary tract amyloidosis, and transurethral biopsy and resection of the intravesical mass were performed under right ureteral stenting. Histopathological diagnosis was amyloidosis. There was no evidence of systemic amyloidosis. To treat residual amyloidosis of the ureter and bladder, we performed occlusive dressing technique therapy using dimethyl sulfoxide every day. After 6 months of therapy, the right hydronephrosis disappeared, and there was no evidence of a recurrence of amyloidosis. We concluded that this therapy was very effective and safe for urinary tract amyloidosis.