{"id":158,"date":"2022-07-21T00:56:17","date_gmt":"2022-07-20T22:56:17","guid":{"rendered":"https:\/\/www.imunomed.ro\/?p=158"},"modified":"2022-07-21T01:01:07","modified_gmt":"2022-07-20T23:01:07","slug":"cistita-acuta-nespecifica-recidivanta-remisa-sub-tratament-cu-prednison","status":"publish","type":"post","link":"https:\/\/www.imunomed.ro\/?p=158","title":{"rendered":"Non specific acute recurrent cystitis treated by Prednisone"},"content":{"rendered":"

The patient <\/span><\/span><\/span>aged<\/span><\/span><\/span> 51 y<\/span><\/span><\/span>e<\/span><\/span><\/span>ars<\/span><\/span><\/span>, <\/b><\/span><\/span>women<\/span><\/span>, since she was a teenager had multiple episodes of nonspecific<\/span><\/span> acute cystitis (<\/span><\/span><\/span><\/span>systematically negative urine <\/span><\/span>cultures<\/span><\/span> and negative urine <\/span><\/span>cultures<\/span><\/span> <\/span><\/span>for <\/span><\/span>BK )<\/span><\/span> <\/span><\/span><\/span><\/span>triggered particularly by the exposure to cold, with <\/span><\/span>non response<\/span><\/span> <\/span><\/span>at AINS (<\/span><\/span> non-steroidal antiinflammator<\/span><\/span>ies ) <\/span><\/span>and non-response at<\/span><\/span> treatment with antibiotics but with very good remission<\/span><\/span> <\/span><\/span><\/span><\/span>to<\/span><\/span> Prednison .<\/span><\/span><\/span><\/span><\/p>\n

<\/span><\/span>P<\/span><\/span>araclinical <\/span><\/span><\/span><\/span>i<\/span><\/span>nvestigati<\/span><\/span><\/span><\/span>ons<\/span><\/span> in normal<\/span><\/span><\/span><\/span> limits <\/span><\/span><\/p>\n

<\/span><\/span>Genital examination combined with ultrasound examination: bilateral ovarian cysts with endometrioma observation<\/span><\/span> <\/span><\/span><\/span><\/span>or dermoid cyst (clinically present dysmenorrhea with prolonged menstruation and severe menstrual pain that ceased to<\/span><\/span> <\/span><\/span><\/span><\/span>injectable Piafen (metamizole + pitophenone + fenpipramide).<\/span><\/span><\/p>\n

There<\/span><\/span> was also suspicion <\/span><\/span><\/span><\/span>of<\/span><\/span> endometriosis because th<\/span><\/span><\/span><\/span>e<\/span><\/span> endometrium had a thickened lining, both ultrasound as well as anatomo-pathology (exam<\/span><\/span><\/span><\/span>ination<\/span><\/span> <\/span><\/span><\/span><\/span>during<\/span><\/span> the total h<\/span><\/span><\/span><\/span>y<\/span><\/span>sterectomy <\/span><\/span><\/span><\/span>with<\/span><\/span> bilateral <\/span><\/span><\/span><\/span>anexectomy<\/span><\/span> by the extirpa<\/span><\/span><\/span><\/span>tion of<\/span><\/span> the uterine cervix <\/span><\/span><\/span><\/span>for<\/span><\/span> the bilateral ovari<\/span><\/span><\/span><\/span>a<\/span><\/span>n cysts <\/span><\/span><\/span><\/span>).<\/span><\/span><\/span><\/span> <\/span><\/span><\/span><\/span>The<\/span><\/span> anatomo-pathologic examination did not show malign<\/span><\/span><\/span><\/span>ant lesions<\/span><\/span> <\/span><\/span><\/span><\/span>only ovarian cysts benign with thickening walls, some of them being hemorrhagic and thickening endometrial mucosa . <\/span><\/span><\/span><\/span><\/p>\n

<\/span><\/span>The peculiarity of the case is that urethr<\/span><\/span>itis and<\/span><\/span> cystitis seems inflammatory without an infectious context, with remission after<\/span><\/span> Prednison. In general, <\/span><\/span><\/span><\/span>its<\/span><\/span> onset <\/span><\/span><\/span><\/span>is<\/span><\/span> at the level of the urethr<\/span><\/span><\/span><\/span>a<\/span><\/span> <\/span><\/span><\/span><\/span>and after<\/span><\/span> the exposure <\/span><\/span><\/span><\/span>to<\/span><\/span> cold (<\/span><\/span><\/span><\/span>therefore,<\/span><\/span> <\/span><\/span><\/span><\/span>a<\/span><\/span> n<\/span><\/span><\/span><\/span>on <\/span><\/span>specific urethritis), <\/span><\/span><\/span><\/span>in<\/span><\/span> a pa<\/span><\/span><\/span><\/span>t<\/span><\/span>ient<\/span><\/span><\/span><\/span> with a history of chronic <\/span><\/span>urticaria<\/span><\/span> (not in the cold, but sometimes after the exposure to solar radiation) <\/span><\/span>and with history of adverse drug reactions .<\/span><\/span><\/p>\n

<\/span><\/span>There<\/span><\/span> seems to be a connection to the hormonal mood, <\/span><\/span><\/span><\/span>because<\/span><\/span> the biops<\/span><\/span><\/span><\/span>y<\/span><\/span> <\/span><\/span><\/span><\/span>from the mucosa <\/span><\/span>urinary<\/span><\/span> bladder (a biopsy performed for diagnosis purposes) showed<\/span><\/span> <\/span><\/span><\/span><\/span>a<\/span><\/span> n<\/span><\/span><\/span><\/span>on <\/span><\/span>specific <\/span><\/span><\/span><\/span>aspect, with<\/span><\/span> <\/span><\/span><\/span><\/span>foci of endometrial metaplasia that are interpreted by the <\/span><\/span>anat<\/span><\/span>h<\/span><\/span>omo-<\/span><\/span>pathologist as nonspecific, common in cystitis. <\/span><\/span><\/p>\n

Dysmenorrhea has had poor progesterone and estro-progestative improvements, so it is likely that there is a lot of ectopic tissue, not only in the urinary mucosa but probably in the genitals.<\/span><\/span><\/p>\n

<\/span><\/span>T<\/span><\/span><\/span><\/span>he p<\/span><\/span><\/span><\/span>e<\/span><\/span>culiarity <\/span><\/span><\/span><\/span>of<\/span><\/span> the case is the <\/span><\/span><\/span><\/span>very<\/span><\/span> good <\/span><\/span><\/span><\/span>response<\/span><\/span> <\/span><\/span><\/span><\/span>to<\/span><\/span> Prednison<\/span><\/span><\/span><\/span>,<\/span><\/span> <\/span><\/span><\/span><\/span>given that the patient had a history with an episode with acute <\/span><\/span> metroanexitis <\/span><\/span><\/span><\/span>good response to<\/span><\/span> Prednison .<\/span><\/span><\/span><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

The patient aged 51 years, women, since she was a teenager had multiple episodes of nonspecific acute cystitis (systematically negative urine cultures and negative urine cultures for BK ) triggered particularly by the exposure to cold, with non response at AINS ( non-steroidal antiinflammatories ) and non-response at treatment with […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[49],"tags":[],"class_list":["post-158","post","type-post","status-publish","format-standard","hentry","category-oncology"],"yoast_head":"\nNon specific acute recurrent cystitis treated by Prednisone - Imunomed<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.imunomed.ro\/?p=158\" \/>\n<meta property=\"og:locale\" content=\"ro_RO\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Non specific acute recurrent cystitis treated by Prednisone - 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