Keller, Joseph J, Liu, Shih-Ping, Lin, Herng-Ching · Neurourology and urodynamics · 2013 · DOI
This study looked at whether people with rheumatoid arthritis (an autoimmune disease that causes joint inflammation) are more likely to have bladder pain syndrome/interstitial cystitis (BPS/IC, a chronic bladder condition). Researchers compared nearly 9,300 people with BPS/IC to over 46,000 people without it, using insurance records from Taiwan. They found that people with BPS/IC were about 1.7 times more likely to have a history of rheumatoid arthritis than those without BPS/IC, even after accounting for other health conditions.
This study is relevant to ME/CFS patients because both conditions share characteristics of chronic pain, potential autoimmune dysfunction, and often co-occur with other centralized pain syndromes. Understanding whether autoimmune diseases like RA are associated with BPS/IC may help explain the autoimmune mechanisms potentially underlying ME/CFS and related conditions. The finding that disease severity (measured by medication intensity) correlates with BPS/IC association suggests exploring similar relationships in ME/CFS.
This study does not establish that rheumatoid arthritis causes bladder pain syndrome, only that the two conditions are statistically associated. Administrative claims data cannot determine whether RA leads to BPS/IC development, whether shared risk factors cause both, or whether overlapping immune dysregulation drives both conditions. The study also cannot explain why the association exists biologically or determine if similar associations exist in non-Taiwanese populations.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Keller, Joseph J, Liu, Shih-Ping, & Lin, Herng-Ching (2013). A case-control study on the association between rheumatoid arthritis and bladder pain syndrome/interstitial cystitis.. Neurourology and urodynamics. https://doi.org/10.1002/nau.22348
BibTeX
@article{mecfsatlas-keller-2013-case-control,
author = {Keller, Joseph J and Liu, Shih-Ping and Lin, Herng-Ching},
title = {A case-control study on the association between rheumatoid arthritis and bladder pain syndrome/interstitial cystitis.},
journal = {Neurourology and urodynamics},
year = {2013},
doi = {10.1002/nau.22348},
note = {PubMed: 23129416},
url = {https://www.mecfsatlas.com/evidence/keller-2013-case-control},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/keller-2013-case-control
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