Prostatitis and Acute Urinary Retention as First Manifestations of Wegener's Granulomatosis

Rapidly recurrent prostatic obstruction due to granulomatosis with polyangiitis

“…Other documented surgical interventions include suprapubic catherization and radical prostatectomy. 1 , 2 Khattak et al documented only four of 26 patients (15%) with prostatitis secondary to GPA requiring TURP, one for gross haematuria, two for bladder outlet obstruction (BOO) and one for recurrent urinary tract infections and BOO. 4 To our knowledge there have been no reported cases of rapid prostatic regrowth requiring multiple TURPs due to GPA.…”

“…While high levels of c-ANCA have a specificity of 99%, their sensitivity of 41%–96% varies with disease extent and severity. 1 Pulmonary biopsy has a sensitivity ranging from 10 to 80% while the sensitivity of biopsies from the nose or sinuses is estimated at 20–50%. 5 …”

“…However there is a strong association with the cytoplasmic and perinuclear antineutrophil cytoplasmic auto-antibodies (c-ANCA, p-ANCA) 1 Diagnosis should be considered if there is clinical, serological (ANCA) and histological evidence of systemic involvement. 1 Differential diagnosis for GPA include the infective causes mycobacterium tuberculosis, blastomyces, dermatitidis brucella species and spirochetes. The systemic inflammatory disorder sarcoidosis should also be considered.…”

“…Classically the upper respiratory tract (92%), lungs (85%) and kidneys (77%) are involved. 1 Prostatic involvement has rarely been reported in systemic GPA. Large series reviewing patients with GPA have noted less than 1% of cases with documented urogenital involvement.…”