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CASE REPORT
Prostatitis, a rare presentation of granulomatosis with polyangiitis, successfully treated with rituximab and prednisone
  1. Muhammad Saad Shaukat1,
  2. Anthony J Ocon1,
  3. Ruben A Peredo2,
  4. Birju D Bhatt1
  1. 1Division of Rheumatology, Department of Medicine, Albany Medical Center, Albany, New York, USA
  2. 2Department of Internal Medicine, Albany Medical Center, Albany, New York, USA
  1. Correspondence to Dr Birju D Bhatt, bhattb30{at}gmail.com

Summary

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.

  • urinary and genital tract disorders
  • vasculitis
  • biological agents

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Footnotes

  • Contributors MSS: the intern resident who was taking care of this patient; was involved in writing the summary, background, case presentation, investigation, treatment, outcome, follow-up, and discussion for this case report. AJO: was the senior resident who was taking care of this patient; involved in writing the summary, background, case presentation, investigation, treatment, outcome, follow-up, and discussion for this case report. BDB and RAP: Rhematology fellows who were taking care of this patient; involved in writing the summary, background, case presentation, investigation, treatment, outcome, follow-up, and discussion for this case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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