Ureteral stenosis secondary to granulomatous vasculitis.
Vasculitic syndromes are a group of disorders characterized by inflammation of the blood vessels. They include polyarteritis nodosa (PAN), Churg-Strauss syndrome (CS), and Wegener granulomatosis (WG) that differ on type, size, and location of the involved vessels. We report a rare case of granulomatous vasculitis leading to ureteral stenosis in the absence of other systemic manifestations of the disease. The patient was a 56-year-old woman who began to complain of left lumbar pain, nocturia, and dysuria. Computed tomography scan demonstrated a large abdominal mass with ureteral compression. A tissue specimen obtained by laparotomy revealed the presence of a chronic inflammatory process with fibrosis, granulomatous reaction, extravascular eosinophilia, and prominent vasculitis. She was put on corticosteroids and azathioprine with a decrease of the tumoral mass. This incompletely classified vasculitis was an unexpected cause of the abdominal mass.
Freitas
Alice Pontes Vilas Boas
AP
Escola Bahiana de Medicina e Saúde Pública/Núcleo de Reumatologia do Hospital Santa Izabel, Bahia, Brazil.
Filho
Humberto Castro Lima
HC
Gonzalez
Fernanda
F
Magalhães
Fernanda
F
Pazos
Manoel Juncal
MJ
Silva
Celso Rubens Vieira E
CR
Santiago
Mittermayer B
MB
D015267:Churg-Strauss Syndrome / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007813:Laparotomy; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014567:Urography