SUMMARY There is increasing awareness that the long‐term use of the non‐steroidal anti‐inflammatory agent tiaprofenic acid (Surgam) is associated with a severe form of cystitis. The condition is usually reversible with complete resolution of symptoms on stopping the drug. We present a case of tiaprofenic acid‐induced cystitis resulting in bilateral hydronephrosis suggesting ureteric obstruction. The previous reported cases are reviewed and the risks of delay in withdrawal of the drug and of permanent ureteric damage are discussed.

Three patients are described in whom renal cell carcinoma was diagnosed between seven months and 14 years after the onset of ulcerative colitis. All three had required treatment with corticosteroids and azathioprine, as well as maintenance therapy with 5-aminosalicylate derivatives, for chronic active colitis. One patient had coexisting polymyalgia rheumatica; one had primary biliary cirrhosis. It is uncertain whether this association, which has not previously been described, has pathogenetic importance or has arisen simply by chance. Genetic predisposition or the effect of drug treatment, particularly immunosuppression, may be pertinent to the co-occurrence of these diseases.