Vasculitis of the bladder: An extremely rare case report.

Int J Surg Case Rep

Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Etienne, France. Electronic address:

Published: August 2013

Introduction: Isolated vasculitis of the bladder is extremely rare. The main causes of which are auto-immune diseases and occasionally infections. Corticosteroid therapy plays a central role in treatment in the majority of cases.

Presentation Of Case: We report a case of gross hematuria associated with irritative low urinary tract symptoms (LUTS) and an increase of biological parameters of inflammation. Radiologic studies suspected a pelvic tumor process. We performed a cystoscopy with multiple biopsies. The pathological findings of the chips were in favor of a thrombotic nongranulomatous vasculitis of small and medium caliber. In view of these findings, all systemic diseases and inflammatory diseases such as cryoglobulinemia, the anti-phospholipid syndrome, Crohn's disease were eliminated. The symptoms regressed completely under antibiotics and anticoagulants.

Discussion: Our treatment options were based on the extent of the acute phase reaction and the pelvic venous thrombosis. A few similar cases have been reported in the literature, particularly a case of isolated necrotizing vasculitis of the bladder involving small vessels with a mild laboratory acute phase reaction which was treated with corticosteroids and cyclophosphamide.

Conclusion: It is important to differentiate this rare pathological feature of the bladder from other bladder tumors as the treatment is medical rather than surgical.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3741461PMC
http://dx.doi.org/10.1016/j.ijscr.2013.06.001DOI Listing

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