Hemorrhagic Cystitis with Giant Cells in Rheumatoid Arthritis Treating with Tacrolimus

ABSTRACT

Hemorrhagic cystitis is a diffuse inflammation of the mucosa of the bladder, characterized by hematuria and burning upon urination. This might be caused by a variety of reasons, including undergoing chemotherapy (such as cyclophosphamide), radiation therapy, bladder cancer, certain viruses, urinary infections, and thrombocytopenia. There are no previous reports of hemorrhagic cystitis associated with the use of tacrolimus. This is the first case of hemorrhagic cystitis due to tacrolimus for the treatment of rheumatoid arthritis. We describe a case of hemorrhagic cystitis with giant cells in a patient with rheumatoid arthritis treating with tacrolimus. Hematuria resolved spontaneously with discontinuation of the drug.