Hemorrhagic cystitis and cytomegalic inclusions in the bladder associated with cyclophosphamide therapy
Hemorrhagic cystitis and cytomegalic inclusions in the bladder associated with cyclophosphamide therapy
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与环磷酰胺治疗相关的出血性膀胱炎和膀胱内巨细胞包涵体
DOI：
10.1002/1097-0142(197001)25:1
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发表时间：
1970
期刊：
影响因子：
6.2
通讯作者：
N. Warner
中科院分区：
文献类型：
--
作者：
R. Goldman;N. Warner
一例严重出血性膀胱炎引起的环磷酰胺治疗。这种并发症很重要，因为如果病因不明，它可能会导致致命的出血。这种损害似乎是由于直接接触药物的尿代谢物造成的，尽管它不是普遍存在的，可能表明相关的遗传或体质因素。及时停药和保守措施通常会缓解症状，但在持续出血的情况下，可能需要充填膀胱造瘘术或尿流改道。值得注意的是，环磷酰胺膀胱炎与辐射引起的变化相似。虽然主要的改变发生在固有层内，但不典型的上皮改变可能与癌混淆。一项独特的发现包括在膀胱中存在巨细胞病毒包涵体。有可能这种感染加重了膀胱损伤，或者损伤的膀胱为病毒提供了一个优先定位的部位。
A case of severe hemorrhagic cystitis resulting from cyclophosphamide administration is presented. This complication is of import because it may lead to fatal hemorrhage if the etiology is unrecognized. The lesion appears to result from direct contact with urinary metabolites of the drug, although its lack of universal occurrence may indicate associated genetic or constitutional factors. Prompt discontinuation of the drug and conservative measures usually alleviate symptoms, but cystostomy with tamponade or urinary diversion may be required in cases of persistent bleeding. The resemblance of cyclophosphamide cystitis to changes produced by irradiation is noted. Although the major alterations occur within the lamina propria, atypical epithelial changes may be confused with carcinoma. A unique finding included the presence of cytomegalovirus inclusions in the bladder. It is possible that bladder damage was potentiated by this infection or that the injured bladder offered a site of preferential localization for the virus.