Urogenital manifestations in Wegener granulomatosis: a study of 11 cases and review of the literature

Dufour, Jean-François; Le Gallou, Thomas; Cordier, Jean-François; Aumaître, Olivier; Pinède, Laurent; Aslangul, Elisabeth; Pagnoux, Christian; Marie, Isabelle; Puéchal, Xavier; Decaux, Olivier; Dubois, Alain; Agard, Christian; Mahr, Alfred; Comoz, François; Boutemy, Jonathan; Broussolle, Christiane; Guillevin, Loïc; Sève, Pascal; Bienvenu, Boris; French Center-East Internists Group, ; ... (2012). Urogenital manifestations in Wegener granulomatosis: a study of 11 cases and review of the literature. Medicine, 91(2), pp. 67-74. Baltimore, Md.: Lippincott Williams & Wilkins 10.1097/MD.0b013e318239add6

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We describe the main characteristics and treatment of urogenital manifestations in patients with Wegener granulomatosis (WG). We conducted a retrospective review of the charts of 11 patients with WG. All patients were men, and their median age at WG diagnosis was 53 years (range, 21-70 yr). Urogenital involvement was present at onset of WG in 9 cases (81%), it was the first clinical evidence of WG in 2 cases (18%), and was a symptom of WG relapse in 6 cases (54%). Symptomatic urogenital involvement included prostatitis (n = 4) (with suspicion of an abscess in 1 case), orchitis (n = 4), epididymitis (n = 1), a renal pseudotumor (n = 2), ureteral stenosis (n = 1), and penile ulceration (n = 1). Urogenital symptoms rapidly resolved after therapy with glucocorticoids and immunosuppressive agents. Several patients underwent a surgical procedure, either at the time of diagnosis (n = 3) (consisting of an open nephrectomy and radical prostatectomy for suspicion of carcinoma, suprapubic cystostomy for acute urinary retention), or during follow-up (n = 3) (consisting of ureteral double J stents for ureteral stenosis, and prostate transurethral resection because of dysuria). After a mean follow-up of 56 months, urogenital relapse occurred in 4 patients (36%). Urogenital involvement can be the first clinical evidence of WG. Some presentations, such as a renal or prostate mass that mimics cancer or an abscess, should be assessed to avoid unnecessary radical surgery. Urogenital symptoms can be promptly resolved with glucocorticoids and immunosuppressive agents. However, surgical procedures, such as prostatic transurethral resection, may be mandatory in patients with persistent symptoms.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology

UniBE Contributor:

Dufour, Jean-François

ISSN:

0025-7974

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:38

Last Modified:

17 Mar 2015 21:30

Publisher DOI:

10.1097/MD.0b013e318239add6

PubMed ID:

22391468

Web of Science ID:

000301119100001

URI:

https://boris.unibe.ch/id/eprint/15209 (FactScience: 222501)

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