PROSTATITIS AS AN INITIAL PRESENTATION FOR GRANULOMATOSIS WITH POLYANGIITIS

Authors

  • Nauman Ismat Butt Azra Naheed Medical College, Lahore Pakistan
  • Raheel Yonus National Hospital and Medical Center, Lahore Pakistan
  • Muhammad Qasim Khan Tareen Sandeman Provinical Hospital, Bolan University of Medical and Health Sciences, Quetta Pakistan
  • Sumaira Farman National Hospital and Medical Center, Lahore Pakistan
  • Nighat Mir Ahmad National Hospital and Medical Center, Lahore Pakistan
  • Amna Ahmad National Hospital and Medical Center, Lahore Pakistan

DOI:

https://doi.org/10.55519/JAMC-04-S4-10658

Keywords:

Granulomatosis with Polyangiitis, Prostatitis, Vasculitis, c-ANCA

Abstract

Granulomatosis with polyangiitis (GPA) is an uncommon pauci-immune small-vessel necrotising granulomatous vasculitis mostly seen in age 45–60 years. We present the case of a formerly healthy 44 years old male presenting with dysuria and intermittent urinary retention for 8 months, not responding to empirical antibiotic therapy and TURP. A prostate biopsy showed necrotising granulomatous prostatitis. Urinalysis demonstrated persistent pyuria and haematuria, but cultures showed no growth. Subsequently he complained of fever, cough, dyspnoea and skin ulcers. CT of the chest showed multiple cavitatory lesions and pleural effusion. On work up, c-ANCA was positive and a diagnosis of granulomatosis with polyangiitis was established. This depicts a rarely seen presentation of prostatitis as the initial feature of GPA.

Author Biographies

Nauman Ismat Butt, Azra Naheed Medical College, Lahore Pakistan

Assistant Professor, Department of Medicine

Raheel Yonus, National Hospital and Medical Center, Lahore Pakistan

Rheumatology Fellow, Department of Rheumatology

Muhammad Qasim Khan Tareen, Sandeman Provinical Hospital, Bolan University of Medical and Health Sciences, Quetta Pakistan

Senior Registrar, Department of Medicine

Sumaira Farman, National Hospital and Medical Center, Lahore Pakistan

Professor and Head, Department of Rheumatology

Nighat Mir Ahmad, National Hospital and Medical Center, Lahore Pakistan

Professor and Chair, Department of Rheumatology

Amna Ahmad, National Hospital and Medical Center, Lahore Pakistan

Senior Registrar, Department of Rheumatology

References

Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 2013;65(1):1–11.

Alba MA, Moreno-Palacios J, Beça S, Cid MC. Urologic and male genital manifestations of granulomatosis with polyangiitis. Autoimmun Rev 2015;14(10):897–902.

Dufour JF, Le Gallou T, Cordier JF, Aumaître O, Pinède L, Aslangul E, et al. French Center-East Internists Group and the French Vasculitis Study Group. Urogenital manifestations in Wegener granulomatosis: a study of 11 cases and review of the literature. Medicine (Baltimore) 2012;91(2):67–74.

Huong DL, Papo T, Piette JC, Wechsler B, Bletry O, Richard F, et al. Urogenital manifestations of Wegener granulomatosis. Medicine (Baltimore) 1995;74(3):152–61.

Khan SA, Subla MR, Behl D, Specks U, Afessa B. Outcome of patients with small-vessel vasculitis admitted to a medical ICU. Chest 2007;131(4):972–6.

Dan D, Fischer R, Adler S, Förger F, Villiger PM. Cyclophosphamide: As bad as its reputation? Long-term single centre experience of cyclophosphamide side effects in the treatment of systemic autoimmune diseases. Swiss Med Wkly 2014;144:w14030.

Chung SA, Langford CA, Maz M, Abril A, Gorelik M, Guyatt G, et al. 2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Antineutrophil Cytoplasmic Antibody-Associated Vasculitis. Arthritis Care Res (Hoboken). 2021;73(8):1366–83.

Masiak A, Zdrojewski Z, Pęksa R, Smoleńska Ż, Czuszyńska Z, Siemińska A, et al. The usefulness of histopathological examinations of non-renal biopsies in the diagnosis of granulomatosis with polyangiitis. Reumatologia 2017;55(5):230–6.

Downloads

Published

2022-10-11

Most read articles by the same author(s)