[Ureteral stenosis in Wegener's granulomatosis. Case report].
BACKGROUND
Ureteral stenoses in Wegener's granulomatosis are rare. They usually involve the pelvic portion of the ureter and are caused by vasculitic lesions or granulomatous inflammation.


METHODS
A 38-year-old woman with Wegener's granulomatosis was treated with corticosteroids and monthly intravenous cyclophosphamide pulses. After 4 months, urinary retention developed, accompanied by lumbar pain, associated with protenuria and hematuria, and related to bilateral ureteral stenoses. Treatment by endoscopic dilatation and double J stents led to with clinical and radiological improvement, while the medical treatment continued.


CONCLUSIONS
Hematuria in patients with Wegener's granulomatosis suggests renal involvement, but ureteral stenoses must also be considered when these patients present hematuria or urinary tract infections. Surgery should be reserved for those patients in whom medical treatment is not rapidly effective.
Ben Ghorbel
Imed
I
Service de médecine interne, Hôpital La Rabta, 1007 Tunis, Tunisie. Electronic address: benghorbelimed@yahoo.com.
Chebbi
Waffa
W
Service de médecine interne, Hôpital La Rabta, 1007 Tunis, Tunisie.
Zouari
Mourad
M
Service de neurologie, Institut de neurologie, 1007 Tunis, Tunisie.
Hentati
Faycel
F
Service de neurologie, Institut de neurologie, 1007 Tunis, Tunisie.
Miled
Mohamed
M
Service de médecine interne, Hôpital La Rabta, 1007 Tunis, Tunisie.
Houman
Mohamed Habib
MH
Service de médecine interne, Hôpital La Rabta, 1007 Tunis, Tunisie.
D000328:Adult; D004106:Dilatation; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D011859:Radiography; D014517:Ureteral Obstruction / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy