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[Case of microscopic polyangiitis presenting initially as prostatic vasculitis]
Eijin Ashikaga1, Masayuki Iyoda, Hiroki Suzuki
1Division of Nephrology, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan.
Prostatic vasculitis can indicate early microscopic polyangiitis (MPA), a small-vessel vasculitis. Early detection via prostate biopsy aids prompt treatment and excellent clinical outcomes for ANCA-associated vasculitis.
Area of Science:
- Nephrology
- Rheumatology
- Pathology
Background:
- Microscopic polyangiitis (MPA) is a type of ANCA-associated vasculitis.
- Elevated prostate-specific antigen (PSA) prompted prostatic biopsy in a 79-year-old male.
- Prostatic involvement is recognized in ANCA-associated vasculitis.
Observation:
- The patient presented with malaise, hematuria, proteinuria, and interstitial pneumonitis.
- Prostatic biopsy revealed vasculitis.
- Renal biopsy demonstrated necrotizing crescentic glomerulonephritis.
Findings:
- Diagnosis of MPA was confirmed by small-vessel vasculitis and positive myeloperoxidase-anti-neutrophil cytoplasmic antibody (MPO-ANCA).
- Prostatic vasculitis served as an early indicator for MPA detection.
- Treatment with methylprednisolone pulse therapy led to effective management.
Implications:
- Prostate biopsy can facilitate early diagnosis of MPA.
- Awareness of prostatic involvement is crucial for diagnosing ANCA-associated vasculitis.
- Early detection and treatment correlate with favorable clinical outcomes.
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