literature on confusable diseases misdiagnosed as BPS/IC
ESSIC uses the name bladder pain syndrome (BPS) instead of interstitial cystitis (IC) and/or painful bladder syndrome (PBS): click here for more details.
A 73-year-old woman with chronic pelvic pain, burning toes, and an eighty-pound weight loss. Birnbaum J, Chai TC, Ali TZ, Polydefkis M, Stone JH. Arthritis Rheum 2008;59:1825-31. • an elderly woman is described with a 5-year history of chronic bladder and pelvic pain, an 80-pound weight loss, a small fiber neuropathy, and interstitial lung disease
• laboratory tests showed a strongly positive rheumatoid factor, and positive ANCA assays associated with perinuclear immunofluorescence and antigen specificity for myeloperoxidase. • bladder biopsies containing bladder mucosa showed no specific abnormalities
• a (false) diagnosis of IC/PBS was made; only after a cystectomy was performed, a necrotizing vasculitis of medium-sized arteries was seen that led to the right diagnosis of microscopic polyangiitis (MPA); disease remission was obtained after adequate treatment for MPA
• it is likely that if deeper bladder biopsies would have been done containing detrusor muscle at initial evaluation, the correct diagnosis could have been made 5 years earlier; moreover, the patient would also have received adequate treatment for a potentially fatal disease 5 years earlier and a cystectomy wouldn't have been necessary
tuberculosis
Dysuria and a headache. Lo S, Noble J, Bowler I, Angus B. Lancet 2004;364:1554
• a case report of a 49-year-old white woman with symptoms of recurrent urinary tract infections; she had no other medical history of note and she had not traveled outside of the UK
• an initial diagnosis of interstitial cystitis was found to be wrong; despite she had no pulmonary disease, the cystitis was found to be due to infection with Mycobacterium tuberculosis
A referral center’s experience with transitional cell carcinoma misdiagnosed as interstitial cystitis. Tissot WD, Diokno AC, Peters KM. J Urol 2004;172:478-80 • a retrospective review of patient records showed that between 1998 and 2002 a total of 600 patients were seen with the diagnosis of interstitial cystitis (IC)
• six patients (1%) previously diagnosed as having IC were found to have transitional cell carcinoma as the cause of symptoms, 4 of whom (67%) had no hematuria
• the authors conclude that patients with irritative voiding symptoms require a thorough evaluation which may include cystoscopy, cytology and upper tract imaging; they expect that the number of wrong diagnoses of IC would increase if the criteria to diagnose IC and initiate treatment were oversimplified
drug-induced cystitis
Eosinophilic cystitis induced by penicillin. Tsakiri A, Balslev I, Klarskov P. Int Urol Nephrol 2004;36:159-61 • a 30-year-old woman developed classic symptoms of painful bladder disease and eosinophilic cystitis as an adverse effect of penicillin for abdominal actinomycosis; the symptoms were reversible after stopping penicillin
Tiaprofenic acid: an uncommon cause of cystitis often misdiagnosed as interstitial cystitis. Heritz DM, Thiessen JJ. Can J Urol 1996;3:202-5
• the authors describe 8 cases of cystitis due to the use of the non-steroidal anti-inflammatory drug tiaprofenic acid but with an initial wrong diagnosis of interstitial cystitis
• discontinuation of the drug will relieve symptoms usually within six weeks.
various
Reinvestigation of patients with a diagnosis of interstitial cystitis: common things are sometimes common. Irwin P, Samsudin A. J Urol 2005;174:584-7 • 61 patients with a provisional diagnosis
of IC underwent reinvestigation. The diagnosis of IC was confirmed
or considered possible in only 34 cases. Common alternative diagnoses
included recurrent urinary tract infections, detrusor overactivity
and vaginal candidiasis. Of 5 male patients only 1 was confirmed
to have IC !
