Urologic and male genital manifestations of granulomatosis with polyangiitis

Autoimmun Rev. 2015 Oct;14(10):897-902. doi: 10.1016/j.autrev.2015.05.012. Epub 2015 May 28.

Abstract

Granulomatosis with polyangiitis (GPA) is a systemic necrotizing granulomatous vasculitis, which predominantly affects small-sized blood vessels. Major organ involvement includes the upper/lower respiratory tract and kidneys. In contrast, genitourinary disease is rare in GPA patients, reported in <1% of cases in large cohorts. Manifestations at this level include prostatitis, destructive urethritis, genital ulcers, orchitis and renal masses. Also, high-dose cyclophosphamide, one of the main immunosuppressive drugs used for GPA treatment, is associated with bladder toxicity, i.e., hemorrhagic cystitis and cancer. Here, we review the main urogenital symptoms associated with this ANCA-associated vasculitis. In addition, cyclophosphamide-induced urologic complications are detailed.

Keywords: ANCA-vasculitis; Bladder toxicity; Cyclophosphamide; Granulomatosis with polyangiitis; Urogenital system; Wegener's granulomatosis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Cyclophosphamide / therapeutic use
  • Granulomatosis with Polyangiitis* / physiopathology
  • Hemorrhage
  • Humans
  • Kidney Diseases / drug therapy
  • Kidney Diseases / pathology
  • Male
  • Urinary Bladder Neoplasms

Substances

  • Cyclophosphamide