tranilast and Cystitis

Topics: Administration, Inhalation; Administration, Oral; Anti-Allergic Agents; Asthma; Contraindications; Cromolyn Sodium; Cystitis; Dermatitis, Atopic; Digestive System Diseases; Drug Eruptions; Hematologic Diseases; Humans; Kidney Diseases; ortho-Aminobenzoates

Topics: Allopurinol; Anti-Inflammatory Agents, Non-Steroidal; Antineoplastic Agents; Cyclophosphamide; Cystitis; Danazol; Estrogen Antagonists; Humans; ortho-Aminobenzoates; Propionates

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.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Cystitis; Eosinophilia; Humans; Male; Middle Aged; ortho-Aminobenzoates; Purpura, Thrombocytopenic, Idiopathic

We report 2 cases of eosinophilic cystitis induced by Tranilast, which was used for the treatment of bronchial asthma. In case 2 Tranilast itself and its metabolic derivative proved to be inciting agents by a drug-induced lymphocyte stimulation test. The literature on this association is reviewed.

Topics: Aged; Asthma; Cystitis; Eosinophilia; Female; Histamine H1 Antagonists; Humans; Male; ortho-Aminobenzoates

A case of tranilast (Rizaben)-induced cystitis accompanied with possibly hypereosinophilic heart syndrome was described. A 75-year-old male, who had been taking tranilast for allergic dermatitis for two months, was admitted for severe bladder stimulating symptoms which was unresponsive to antibiotic therapies. Clinical examination revealed tenderness of the prostate, aseptic pyuria, eosinophilia, liver dysfunction and electrocardiographic disorders including atrial fibrillation, T-wave inversions and lowered ST segment without any cardiac symptoms. Cystitis symptoms, pyuria, eosinophilia and liver dysfunction improved within several days after discontinuance of tranilast, and ST-T changes on ECG gradually normalized within a few months. Tranilast-induced cystitis has been demonstrated as a type of eosinophilic cystitis. Since pathologic findings of eosinophilic cystitis and hypereosinophilic heart syndrome are markedly similar and all symptoms and signs disappeared after deprivation of tranilast, it appears likely that eosinophilic inflammation was induced to the heart, liver, bladder and prostate of the current patient by tranilast.

Topics: Aged; Cystitis; Dermatitis, Allergic Contact; Electrocardiography; Eosinophilia; Heart; Heart Diseases; Histamine H1 Antagonists; Humans; Male; ortho-Aminobenzoates

Tranilast (N-(3,4-dimethoxycinnamoyl)anthranilic acid), an anti-allergic drug, has been developed and used for the treatment of anaphylactic hypersensitivity such as bronchial asthma in Japan. Recently, many cases with eosinophilic cystitis associated with administration of this drug have been reported. In a series of studies to elucidate the pathoetiology of this unusual cystitis, the distribution of tranilast in urinary bladder of rats was investigated. Light microscopic radioautography using tritiated tranilast showed that this drug was localized specifically in the transitional epithelial cells of the mucosa and the endothelial cells of venous vessels for a fairly long time after an oral administration. These results should be taken into consideration in further studies of this drug-associated cystitis.

Topics: Animals; Autoradiography; Cystitis; Male; Microscopy; ortho-Aminobenzoates; Rats; Rats, Inbred Strains; Urinary Bladder

We encountered 8 cases of cystitis probably caused by Tranilast. Bladder biopsy performed on 6 of the 8 cases revealed eosinophilic cystitis in 3 cases. In the lymphocyte stimulation test using Tranilast as an antigen, a positive and false positive reaction was seen in one case each. This disease seemed to occur as a result of allergy of the bladder specific to Tranilast.

Topics: Adult; Aged; Asthma; Cystitis; Eosinophilia; Female; Humans; Lymphocyte Activation; Male; Middle Aged; ortho-Aminobenzoates

The cytomorphologic features of voided urine specimens from two patients with antiallergic drug (Tranilast)-induced eosinophilic cystitis are described. The urothelial cells tend to occur in clusters and are of variable size. The remarkable vacuolization is observed in the cytoplasm. The markedly vacuolated cytoplasm which may be infiltrated by polymorpho-nuclear leucocytes is unremarkable. Some nuclei usually show transparent center surrounded by a rim of chromatin. The nucleoli are prominent. Marked vacuoles in the nucleus is observed. These findings are very important cytomorphologic characteristics for differential diagnosis between eosinophilic cystitis and malignant bladder tumor and cystitis due to bacterial infection.

Topics: Aged; Asthma; Cystitis; Diagnosis, Differential; Eosinophils; Female; Humans; Male; Middle Aged; ortho-Aminobenzoates; Urinary Bladder Neoplasms; Urine

Eosinophilic cystitis developed in an asthmatic patient after therapy with the antiasthmatic agent, Tranilast. The progress of this patient and the histopathologic findings of bladder biopsy specimens are reported. A review of recent publications on the possible causative correlations is presented. It appears judicious to perform bladder biopsy if common chemotherapy fails to improve bladder irritability in patients receiving Tranilast therapy. If a diagnosis of eosinophilic cystitis induced by Tranilast is established, immediate withdrawal of the drug with or without steroid therapy is recommended.

Topics: Cystitis; Eosinophils; Female; Humans; Microscopy, Electron; Middle Aged; ortho-Aminobenzoates

First, the cases of two patients with intractable cystitis are presented. The first case was a 72-year old man who was admitted to our clinic with bladder symptoms (pollakisuria, pain on urination, hematuria and so forth) for about one month. These symptoms were not relieved by several kinds of antibiotic therapy. For the previous three months he had been suffering from asthma bronchiale. Rizaben (tranilast) was administered for more than two months. An excretory urogram showed normal renal function, but a small bladder with trabeculation. Voiding cystourethrograms revealed bilateral VUR. Cystoscopy disclosed remarkable red areas in the bladder mucosa. A bladder biopsy was done and the pathological finding was cystitis chronica. Intravesical installation of AgNO3, steroid administration, anti-histamic and anti-allergic therapy did not resolve these symptoms. However, Chinese medicines (Chorêto and Ryutanshakantõ) were effective. The second case was a 39-year old woman who visited our clinic complaining of bladder symptoms with hematuria for more than two months. In the past, she had suffered from asthma bronchiale. Rizaben (tranilast) was administered for three months. On cystoscopic examination, a small amount of intravesical coagula and erythematous, edematous areas with petechiae, were observed. The intravesical installation of AgNO3, anti-histamic and antiallergic therapy and gamma-globulin were not effective, but Chinese medicine was effective. Two other cases of cystitis due to Rizaben are presented briefly. Including our cases, 24 cases of cystitis chronica or eosimophilic cystitis due to Rizaben have been reported recently.

Topics: Adult; Aged; Asthma; Cystitis; Female; Humans; Male; ortho-Aminobenzoates; Urinary Bladder