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Rheumatology International

, Volume 39, Issue 7, pp 1269–1277 | Cite as

Prostate involvement in granulomatosis with polyangiitis

  • Roman Yatsyshyn
  • Olena Zimba
  • Mykola Bahrii
  • Bohdana DoskaliukEmail author
  • Vitalii Huryk
Case Based Review
  • 66 Downloads

Abstract

To present a case of prostate involvement (PI) in granulomatosis polyangiitis (GPA) and analyse related published reports. We employed the following keywords for retrieving reports indexed by MEDLINE/PubMed and/or Scopus: “granulomatosis with polyangiitis”, “Wegener granulomatosis” and “prostate involvement”. Additional searches were performed through Google Scholar and HINARI. All cases that fulfilled the American College of Rheumatology criteria for GPA, standards of Chapel Hill Consensus Conference, and did not match with exclusion criteria were analysed and summarised. A 35-year-old man presented with complaints of stuffy nose, difficulty breathing through the nose, swelling and pain in the left half of the nose, low-grade fever, and discomfort. The nasal mucosal biopsy did not reveal any specific changes. During the inpatient treatment, he developed eye redness, tearing, dysuria, and decreased urinary stream. Prostate-specific antigen (PSA) was elevated (2.81 μg/L; normal values ≤ 1.4 μg/L for males below 40 years). Prostate biopsy findings were consistent with diagnosis of GPA, which was confirmed by detecting elevated anti-PR3 antibodies (4.1 IU; normal values < 1.0 IU). We analysed our case in view of the clinical course of 45 published cases of PI in GPA. PI in GPA is a rare clinical manifestation of the vasculitis. Patients with atypical clinical symptoms of GPA are at risk of delayed diagnosis. The awareness of variable clinical presentations of GPA, particularly specific affection of the prostate gland, is crucial for timely diagnosis.

Keywords

Granulomatosis with polyangiitis Prostate Urogenital system Urological manifestations 

Notes

Author contributions

RY supervised the patient management, interpreted the obtained data, and edited manuscript. OZ manuscript writing and revision, took part in the consultations for the reported case. MB performed pathomorphological examination, interpreted the data, and revised the manuscript. BD collected data and wrote the initial version of the manuscript, took part in the consultations for the reported case. VH took part in the patient management and manuscript writing. All authors approved the final manuscript for publication.

Funding

No funding was received for this study.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Written informed consent was obtained from the patient reported in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Internal Medicine #1, Clinical Immunology and Allergology Named After Academician Ye. M. NeikoIvano-Frankivsk National Medical UniversityIvano-FrankivskUkraine
  2. 2.Department of Internal Medicine #2Danylo Halytsky Lviv National Medical UniversityLvivUkraine
  3. 3.Department of Pathomorphology and Legal MedicineIvano-Frankivsk National Medical UniversityIvano-FrankivskUkraine
  4. 4.Department of UrologyRegional Clinical Hospital of Ivano-FrankivskIvano-FrankivskUkraine

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