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Case Reports
. 2018 Aug 14:2018:bcr2018225379.
doi: 10.1136/bcr-2018-225379.

Prostatitis, a rare presentation of granulomatosis with polyangiitis, successfully treated with rituximab and prednisone

Muhammad Saad Shaukat  1 , Anthony J Ocon  1 , Ruben A Peredo  2 , Birju D Bhatt  1
Affiliations
Case Reports

Prostatitis, a rare presentation of granulomatosis with polyangiitis, successfully treated with rituximab and prednisone

Muhammad Saad Shaukat et al. BMJ Case Rep. .

Abstract

A previously healthy 21-year-old man presented with an 8-month history of weight loss, lethargy and dysuria unresponsive to empiric antibiotics and paraurethral drainage of a prostatic abscess. Urinalysis showed pyuria, but cultures failed to grow any organisms. Additionally, he developed new onset sensorineural hearing loss. CT of the chest showed two right-sided cavitary lesions. CT of the abdomen and pelvis demonstrated a prostatic abscess. A prostate biopsy demonstrated necrotising granulomatous prostatitis. A lung biopsy showed necrotising granulomatous inflammation. He was diagnosed with granulomatosis with polyangiitis (GPA). He was successfully treated with rituximab and prednisone. At 6-month follow-up, he continued to be in remission with resolution of his symptoms. This case demonstrates a rare presentation of prostatitis as the presenting symptom of GPA. As far as we know, this case is the first documented report of rituximab and prednisone as successful therapy for prostatitis secondary to GPA.

Keywords: biological agents; urinary and genital tract disorders; vasculitis.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
CT abdomen/pelvis. An enlarged prostate with abscess is noted.
Figure 2
Figure 2
CT chest with contrast. Arrow denotes cavity lesion noted in the superior region of the right lower lobe of the lung.
Figure 3
Figure 3
CT chest with contrast. Arrow denotes cavity lesion noted in the anterior region of the right lower lobe of the lung.
See this image and copyright information in PMC

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