トラニラストによる好酸球性膀胱炎の1例

Abstract

肉眼的血尿及び膀胱刺激症状を呈した62歳男で, 1980年以降特発性血小板減少性紫斑病の為にプレドニゾロンが投与されていた.過去18ヵ月間トラニラストが投与されていた.尿中好酸球数が著増していた.膀胱鏡検査では膀胱粘膜全体に発赤, 浮腫が見られた.逆行性膀胱造影で両側の不完全膀胱尿管逆流を認めた.膀胱生検試料は好酸球数の著増を示したが, 肥満細胞数は増加していなかった.トラニラスト投与中止後1週間以内に症状は消失した

We report a patient with tranilast-induced eosinophilic cystitis who had no allergies, but had been administered tranilast to reduce prednisolone. A 62-year-old man presented with macroscopic hematuria and bladder irritative symptoms. The patient had a past medical history of idiopathic thrombocytopenic purpula and had been treated with 15 mg of prednisolone since 1980. He had been receiving 300 mg of tranilast for the past 18 months. Urinalysis revealed a marked increase in eosinophils (4 x 10(4)/ml). A cystoscopic examination revealed reddish mucosa throughout the bladder. A retrograde cystogram showed incomplete bilateral vesicoureteral reflux. Histological examinations of biopsied bladder specimens revealed a marked increase in the number of eosinophils (1, 126/mm2), but not of mast cells (12/mm2). The symptoms resolved within one week after cessation of tranilast.