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以“前列腺脓肿”为首发表现的肉芽肿性多血管炎(韦格纳肉芽肿)

'Prostate Abscess' as the Initial Manifestation of Granulomatosis with Polyangiitis (Wegener's Granulomatosis).

作者信息

Tsiodras Sotirios, Poulakou Garyfalia, Leventakos Konstantinos, Panopoulou Helen, Elezoglou Antonia, Manoloudaki Kassiani, Chrisofos Michail, Petrikkos George, Panayiotides Ioannis G

机构信息

4th Department of Internal Medicine, University of Athens Medical School, x2018;Attikon' University Hospital, Athens, Greece.

出版信息

Urol Int. 2016;96(2):244-6. doi: 10.1159/000363113. Epub 2014 Aug 13.

Abstract

Prostatic involvement in granulomatosis with polyangiitis (GWP), formerly known as Wegener's granulomatosis, is rare, mostly arising in the context of systemic involvement. Prostatic involvement as the first manifestation of this systemic disease is exceptionally rare. We hereby present the case of a 41-year-old male patient who underwent transurethral prostate resection for what was initially diagnosed as suppurative, focally necrotizing prostatitis. Prolonged postoperative fever that did not respond to various treatments, as well as the subsequent appearance of a left pleural effusion, a left upper pulmonary lobe lesion and cutaneous nodules, led to a reevaluation of histological slides which, along with the determination of serum c-ANCA/anti-PR3 antibody levels, established the diagnosis of GWP. Physicians, and especially urologists and infectious diseases specialists, should be aware of this rare association and consider GWP in the event of nonresolving prostatitis, especially when characteristic symptoms from other systems appear.

摘要

前列腺受累于肉芽肿性多血管炎(GWP,既往称为韦格纳肉芽肿)较为罕见,大多发生在全身受累的情况下。前列腺受累作为这种全身性疾病的首发表现极为罕见。我们在此报告一例41岁男性患者,该患者因最初诊断为化脓性、局灶性坏死性前列腺炎而接受了经尿道前列腺切除术。术后持续发热,对各种治疗均无反应,随后出现左侧胸腔积液、左上肺叶病变和皮肤结节,促使对组织学切片进行重新评估,结合血清c-ANCA/抗PR3抗体水平的测定,确诊为GWP。医生,尤其是泌尿科医生和传染病专家,应意识到这种罕见的关联,在前列腺炎经久不愈时,尤其是出现其他系统的特征性症状时,应考虑GWP。

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