前立腺炎様症状を契機に発見されたWegener肉芽腫症

WEGENER'S GRANULOMATOSIS PRESENTING AS A PROSTATITIS: A CASE REPORT

　症例は49歳。急性前立腺炎の診断にて抗生剤の投与を行うも，改善は認められなかった。鼻出血出現し，鼻腔内の生検にてWegener肉芽腫症の診断を得た。プレドニゾロン，サイクロホスファミドの投与にて，病状は急速に改善した。前立腺生検では，壊死性肉芽腫性前立腺炎で，Wegener肉芽腫症の治療後の所見として矛盾しなかった。Wegener肉芽腫症による前立腺病変は稀であり，特に前立腺病変で発症した症例は数例の報告しかない。

The patient was a 49-year-old man with chief complaints of fever up and acute urinary retention. His urine contained 20-30 white blood cells per high power field and his prostate gland was warm, swollen and fluctuant in consistency on rectal examination. Prostatic abscess was suspected in transrectal ultra sonography and computed tomography. Therapy with antimicrobial agents was started immediately, but patient's response was poor. Nasal biopsy was carried out because of nasal bleeding. The biopsy specimen showed Wegener's granulomatosis. Prostatic involvement in Wegener's granulomatosis was suspected.