Polyarteritis nodosa presenting with frank hematuria

Abstract

Polyarteritis nodosa (PAN) is an uncommon systemic vasculitis characterized by necrotizing inflammation of small-or mediumsized arteries. The disease normally presents with non-specific symptoms. Urological symptoms at presentation are extremely rare. We report a 65-year-old man who was diagnosed with a polyarteritis nodosa having presented atypically with left testicular pain and swelling, and an intratesticular lesion. He developed painless visible hematuria while under investigation. No gross arterio-venous fistula was seen to suggest a false aneurysm. Subsequently, laboratory studies showed positive anti-neutrophil cytoplasmic antibody levels and a raised erythrocyte sedimentation rate. This was an unusual presentation of PAN diagnosed with multidisciplinary input from the urology, radiology and nephrology teams.

Minocycline-Induced Polyarteritis Nodosa Presenting With Testicular Pain: A Case Report and Selected Review of the Literature

“…Many clinicians often neglect to consider testicular pain as a presenting symptom of vasculitis. To our best knowledge, our patient is the youngest of all the patients who had testicular pain as an initial manifestation of systemic PAN ( Table 1, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]). In addition to testicular pain, our patient displayed diffuse myalgias, unexplained weight loss meeting the diagnosing criteria for PAN [19].…”