Recurrent obstructive prostatitis revealing granulomatosis with polyangiitis.

Area of Science:

• Rheumatology
• Nephrology
• Pulmonology

Background:

• Granulomatosis with polyangiitis (GPA) is a systemic vasculitis characterized by antineutrophil cytoplasmic antibodies (ANCA).
• GPA typically affects small blood vessels, leading to inflammation primarily in the respiratory tract and kidneys.
• Urogenital involvement in GPA is uncommon and infrequently documented in medical literature.

Observation:

• A 46-year-old immunocompetent individual presented with recurrent urinary tract infections and difficulty emptying the bladder (bladder retention).
• Incidental radiological findings included sinusitis and a pulmonary mass.
• These clinical and radiological features prompted further investigation into a potential systemic inflammatory condition.

Findings:

• The patient was diagnosed with Granulomatosis with polyangiitis (GPA).
• The diagnosis was confirmed despite the absence of typical respiratory or renal manifestations, with urogenital symptoms being the primary clinical presentation.
• This case underscores the atypical manifestations of GPA.

Implications:

• This case expands the understanding of GPA's clinical spectrum, particularly its rare urogenital presentations.
• Physicians should consider GPA in the differential diagnosis of patients with unexplained urogenital symptoms, even in the absence of classic signs.
• Early recognition of atypical GPA presentations is crucial for timely and appropriate management, potentially preventing severe organ damage.