What is your approach to the diagnosis and management of lupus cystitis?

Lupus cystitis is a rare complication of lupus but there does appear to be an association. I depend on the urologist to confirm the diagnosis of interstitial cystitis. If mild to moderate in activity, will use standard treatments for cystitis with bladder infusions, bladder relaxants in collaboration with the urologist. If severe, will do a prednisone boost up to 0.5mg/kg a day followed by a taper over 3-4 weeks. In very severe cases, there are reports of using medrol pulses. In the refractory c...

@Dr. First Last gives some great advice. I'll add a few things.

This is a rare entity seen almost exclusively in Asians. I've had two patients in 30 years (that is how rare). Some important caveats:

1. The literature is very confusing. Many articles label it "interstitial cystitis." However, this is not the same entity as the interstitial cystitis we think of with fibromyalgia. That term should not be used and "lupus cystitis" should be the correct term.
2. Most of these patients, including both of m...