A Case of Hemorrhagic Cystitis that Developed During Administration of Cyclophosphamide for Idiopathic Thrombocytopenic Purpura Successfully Treated with Kamikihito / 日本東洋医学雑誌

ABSTRACT

A 71-year-old woman was referred to our hospital with complaints of gross hematuria. She had been administered 50mg/day of cyclophosphamide for 13 years to treat idiopathic thrombocytopenic purpura (ITP). Cystoscopy revealed irregular surface of bladder mucosa. On suspicion of bladder cancer, we performed transurethral resection of bladder tumor (TURBT). The pathological examination showed polypoid cyst, and we diagnosed hemorrhagic cystitis. Two months after the operation, gross hematuria was observed again. Although we administered choreitogoshimotsuto and then saireito, both were ineffective. Then we administered kamikihito, considering the findings of deficiency of ki (qi) and ketsu (blood) in Kampo diagnosis and the underlying disease ITP. One month after administering kamikihito, gross hematuria disappeared, urinary sediment test showed RBC 1-4/HPF. After one year of follow-up, bladder tumor was suspected by cystoscopy, but the pathological result of the second TUR-BT was inflammatory change. Since then, kamikihito was continued during the 44-month observation period, and no gross hematuria was observed.