A Case of Pemphigus Vulgaris in Association with Malakoplakia of the Urinary Tract

Abstract

　A 59-year-old woman had been treated for pemphigus vulgaris for over 20 years. Currently the treatment is with prednisolone 10 mg/day and azathioprine 100 mg/day. The symptoms were mild ulcers in the oral cavity and erosions on the eyelids. The patient had developed bladder inflammation symptoms, anemia and hematuria 2 years previously. Computed tomography revealed a left renal pelvic tumor and hydronephrosis. Tumor masses in the bladder were detected by both cystoscopy and magnetic resonance imaging. Transurethral bladder tumor resection and ureteroscopy were performed. Malakoplakia was diagnosed as there was some collection of histiocytes with Michaelis-Gutmann bodies. Urinary culture detected Escherichia coli. The bladder masses had disappeared and the size of left renal pelvic tumor had beenreduced by oral administration of antibiotics. We considered that the urinary tract Malakoplakia developed under an immunocompromised condition due to treatment of pemphigus vulgaris.