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CASE REPORT
Year : 2011  |  Volume : 27  |  Issue : 2  |  Page : 272-273

Hyperbaric oxygen-A new horizon in treating cyclophosphamide-induced hemorrhagic cystitis


1 Department of Internal Medicine, Medical College, Trivandrum, India
2 Internal Medicine, University of Pittsburgh Medical Center, PA, USA
3 Institute of Aerospace Medicine, IAF, Bangalore, India

Correspondence Address:
S Ajith Kumar
KP 12/99, "krishna", Christ Nagar Road, Vazhayila, Karakulam PO, Trivandrum - 695 564
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-1591.82849

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Hemorrhagic cystitis consists of acute or insidious diffuse bleeding from the bladder mucosa. It can be caused by radiation, drugs, autoimmune diseases, viral and bacterial infections, etc. Hemorrhagic cystitis is a well-recognized complication of cyclophosphamide therapy and it can be potentially fatal. We discuss two cases of cyclophosphamide-induced hemorrhagic cystitis where outcome of conventional management was not satisfactory and a novel therapy using hyperbaric oxygen was used. Hyperbaric oxygen therapy (HBOT) reduces inflammation, stimulates neoangiogenesis, maintains tissue oxygenation and heals tissue hypoxia and radio necrosis. Patients received 100% oxygen in a hyperbaric chamber at 2.5 atmosphere absolute (ATA) for 90 minutes, 5 days a week. One patient was given 36 sessions and the other was given 19 sessions of HBOT. HBOT resulted in complete cessation of bleeding; no side effect was noted during the course of therapy. There was no relapse after 12 months of cessation of treatment. In future, this form of therapy can offer a safe alternative in the treatment of cyclophosphamide-induced hemorrhagic cystitis.


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