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June 30, 1978

Scleroderma Involving the Urinary Bladder

JAMA. 1978;239(26):2760. doi:10.1001/jama.1978.03280530024012

To the Editor.—  We report a case of progressive systemic sclerosis (scleroderma) that we believe involves the urinary bladder.

Report of a Case.—  A 33-year-old woman was noted in 1971 as having Raynaud's phenomenon. This progressed with skin changes of the hands, forearms, and face that led to the diagnosis of scleroderma in 1974. In September 1976 she was treated for vaginitis and a urinary tract infection, but she continued to complain of frequency. A cystometrogram showed a small bladder (150-ml capacity) with normal contractility.The patient came to us in May 1977 with the complaint of frequency, voiding every four hours during the day and night. We found a maximum bladder capacity of 250 ml with no residual urine and normal contractility. Cystoscopy showed a pale epithelial surface containing blood vessels with attenuated branches, an appearance similar to a postirradiation bladder. The patient refused permission for a bladder biopsy.

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