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Rheumatology International

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28.05.2019 | Cases with a Message

Urethral involvement in granulomatosis with polyangiitis: a case-based review

verfasst von: Hamdy M. A. Ahmed, Mohanad M. Elfishawi, Ahmed Hagiga, Ibrahim M. A. Ahmed, Ya Li Chen

Erschienen in: Rheumatology International | Ausgabe 7/2019

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Abstract

Granulomatosis with polyangiitis (GPA) commonly presents with glomerulonephritis and inflammation of upper and lower respiratory tracts. It can also involve other organs including those of the urinary tract. The involvement of the urethra is very rarely reported. We present a case of GPA in a patient who had recurrent urinary tract infections and an acute bladder outlet obstruction due to a urethral thickening by GPA. In this report, we discuss urethral involvement with GPA. The incidence of such involvement, as with other urinary tract organs, might be underestimated. It can affect both sexes, with male predominance, and can occur at any age. It responds to standard GPA medical treatment but may require surgical intervention. Rheumatologists should be aware of this limited form of GPA as early recognition and treatment can decrease the risk of complications.

Jennette JC, Falk RJ (1997) Small-vessel vasculitis. N Engl J Med 337(21):1512–1523. https://doi.org/10.1056/nejm199711203372106 CrossRefPubMed

Lutalo PM, D’Cruz DP (2014) Diagnosis and classification of granulomatosis with polyangiitis (aka Wegener’s granulomatosis). J Autoimmun 48–49:94–98. https://doi.org/10.1016/j.jaut.2014.01.028 CrossRefPubMed

Seo P, Stone JH (2004) The antineutrophil cytoplasmic antibody-associated vasculitides. Am J Med 117(1):39–50. https://doi.org/10.1016/j.amjmed.2004.02.030 CrossRefPubMed

Jayne D (2009) The diagnosis of vasculitis. Best Pract Res Clin Rheumatol 23(3):445–453. https://doi.org/10.1016/j.berh.2009.03.001 CrossRefPubMed

Reinhold-Keller E, Beuge N, Latza U, De Groot K, Rudert H, Nölle B et al (2000) An interdisciplinary approach to the care of patients with Wegener’s granulomatosis: long-term outcome in 155 patients. Arthritis Rheum 43(5):1021–1032CrossRefPubMed

Group TWR (2002) Design of the Wegener’s granulomatosis etanercept trial (WGET). Control Clin Trials 23(4):450–468CrossRef

Stone JH (2003) Limited versus severe Wegener’s granulomatosis: baseline data on patients in the Wegener’s granulomatosis etanercept trial. Arthritis Rheum 48(8):2299–2309. https://doi.org/10.1002/art.11075 CrossRefPubMed

Schnabel A, Holl-Ulrich K, Dalhoff K, Reuter M, Gross WL (1997) Efficacy of transbronchial biopsy in pulmonary vaculitides. Eur Respir J 10(12):2738–2743CrossRefPubMed

Masiak A, Zdrojewski Z, Pęksa R, Smoleńska Ż, Czuszyńska Z, Siemińska A et al (2017) The usefulness of histopathological examinations of non-renal biopsies in the diagnosis of granulomatosis with polyangiitis. Reumatologia 55:230–236. https://doi.org/10.5114/reum.2017.71638 CrossRefPubMedPubMedCentral

10.

de Souza FH, Radu Halpern AS, Valente Barbas CS, Shinjo SK (2010) Wegener’s granulomatosis: experience from a Brazilian tertiary center. Clin Rheumatol 29(8):855–860. https://doi.org/10.1007/s10067-010-1408-4 CrossRefPubMed

11.

Alba MA, Moreno-Palacios J, Beca S, Cid MC (2015) Urologic and male genital manifestations of granulomatosis with polyangiitis. Autoimmun Rev 14(10):897–902. https://doi.org/10.1016/j.autrev.2015.05.012 CrossRefPubMed

12.

Huong DL, Papo T, Piette JC, Wechsler B, Bletry O, Richard F et al (1995) Urogenital manifestations of Wegener granulomatosis. Medicine (Baltimore). 74(3):152–161CrossRefPubMed

13.

Dufour JF, Le Gallou T, Cordier JF, Aumaitre O, Pinede L, Aslangul E et al (2012) Urogenital manifestations in Wegener granulomatosis: a study of 11 cases and review of the literature. Medicine (Baltimore). 91(2):67–74. https://doi.org/10.1097/MD.0b013e318239add6 CrossRefPubMed

14.

Davenport A, Downey SE, Goel S, Maciver AG (1996) Wegener’s granulomatosis involving the urogenital tract. Br J Urol 78(3):354–357. https://doi.org/10.1046/j.1464-410X.1996.00166.x CrossRefPubMed

15.

Fowler M, Martin SA, Bowles WT, Packman R, Katzenstein A-L (1979) Wegener granulomatosis Unusual cause of necrotizing urethritis. Urology 14(1):66–69CrossRefPubMed

16.

Jensen KE, Nielsen K, Kock K (1982) Necrotising urethritis in Wegener’s granulomatosis. Br J Urol. 54(4):434CrossRef

17.

Dore B, Duriez P, Grange P, Aubert J (1990) Wegener’s granulomatosis with urethral-penile location: Apropos of a case. Ann Urol 24(3):256–258

18.

Weiss R, Hrehorovich V (1991) An unusual manifestation of Wegener’s granulomatosis. Md Med J (Baltimore, Md: 1985) 40(4):271

19.

Ter Maaten J, Franssen C, Daenekindt A, Hoorntje S (1993) Triple Wegener’s granulomatosis in the urogenital tract. Nephron 63(3):358–359CrossRefPubMed

20.

Zielonka T, Madalinska M, Droszcz W, Pogorzelski R, Borkowski A (1995) Urethral stricture as unusual complications of Wegener’s granulomatosis. Neth J Med 46(5):236–238CrossRefPubMed

21.

Linehan J, Bhakri H (1995) Penile granulomas with urethral stricture: unusual presentation of Wegener’s granulomatosis. Br J Clin Pract 49(1):47PubMed

22.

Ebo D, Mertens A, De Clerck L, Gentens P, Daelemans R (1998) Relapse of Wegener’s granulomatosis presenting as a destructive urethritis and penile ulceration. Clin Rheumatol 17(3):239–241CrossRefPubMed

23.

Sharma A, Gopalakrishan D, Nada R, Kumar S, Dogra S, Aggarwal MM et al (2014) Uncommon presentations of primary systemic necrotizing vasculitides: the Great Masquerades. Int J Rheum Dis 17(5):562–572CrossRefPubMed

24.

Soro Marín S, Júdez Navarro E, Sianes Fernández M, Sánchez Nievas G, Romero JGL (2017) An Unusual presentation of limited granulomatosis with polyangiitis involving vagina and urethra. Case Rep Rheumatol. https://doi.org/10.1155/2017/9407675 CrossRefPubMedPubMedCentral

25.

Anderson PT, Gottheil S, Gabril M, Barra L, Power N (2017) Acute urinary retention secondary to urethral involvement of granulomatosis with polyangiitis. Can Urol Assoc J 11(1–2):E38CrossRefPubMedPubMedCentral

26.

Nielsen K, Jensen K, Kock K (1981) Wegener’s granulomatosis. A brief review and report of an unusual course with urethral localization. Ugeskrift for laeger 143(16):1003PubMed

27.

Hoffman GS, Kerr GS, Leavitt RY, Hallahan CW, Lebovics RS, Travis WD et al (1992) Wegener granulomatosis: an analysis of 158 patients. Ann Intern Med 116(6):488–498CrossRefPubMed

28.

Tomasson G, Grayson PC, Mahr AD, LaValley M, Merkel PA (2012) Value of ANCA measurements during remission to predict a relapse of ANCA-associated vasculitis—a meta-analysis. Rheumatology (Oxford) 51(1):100–109. https://doi.org/10.1093/rheumatology/ker280 CrossRef

29.

Kemna MJ, Damoiseaux J, Austen J, Winkens B, Peters J, van Paassen P et al (2015) ANCA as a predictor of relapse: useful in patients with renal involvement but not in patients with nonrenal disease. J Am Soc Nephrol 26(3):537–542. https://doi.org/10.1681/asn.2013111233 CrossRefPubMed

Titel: Urethral involvement in granulomatosis with polyangiitis: a case-based review
verfasst von: Hamdy M. A. Ahmed
Mohanad M. Elfishawi
Ahmed Hagiga
Ibrahim M. A. Ahmed
Ya Li Chen
Publikationsdatum: 28.05.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Rheumatology International / Ausgabe 7/2019
Print ISSN: 0172-8172
Elektronische ISSN: 1437-160X
DOI: https://doi.org/10.1007/s00296-019-04331-7

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