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Polyarteritis nodosa mimicking prostatic cancer.

O González-La Riviere1, F de la Torre-Rendón, R Hernández-Vásquez

  • 1Mexican Society of Rheumatology, Mexico.

The Journal of Rheumatology
|October 19, 2000
PubMed
Summary

A 72-year-old man with elevated prostate-specific antigen (PSA) was diagnosed with polyarteritis nodosa (PAN), not prostate cancer. This case highlights PAN

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Area of Science:

  • Rheumatology
  • Urology
  • Pathology

Background:

  • Prostate-specific antigen (PSA) is a tumor marker for prostate cancer.
  • Elevated PSA levels can indicate various prostatic conditions.

Observation:

  • A 72-year-old male presented with prostate enlargement, elevated PSA (35 ng/dl), polyarthritis, and constitutional symptoms.
  • Initial prostatic ultrasonography suggested malignancy, but biopsy revealed polyarteritis nodosa (PAN).
  • The patient subsequently developed neurological symptoms (paresthesia, dysesthesia), renal dysfunction, and hypertension.

Findings:

  • Polyarteritis nodosa (PAN) can present with diverse and unusual symptoms.
  • PAN can mimic other conditions, including prostate cancer, based on initial clinical presentation and PSA levels.
  • Systemic vasculitis, like PAN, can affect multiple organ systems, including the prostate and kidneys.

Implications:

  • This case expands the differential diagnosis for elevated PSA levels, particularly in patients with systemic symptoms.
  • It underscores the importance of considering systemic inflammatory and autoimmune diseases in the differential diagnosis of prostatic conditions.
  • Early recognition and treatment of PAN with immunosuppressants (steroids, cyclophosphamide) can lead to significant clinical improvement.

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