Urological Manifestations of the Systemic Vasculitides—A Scoping Review
Abstract
:1. Introduction
2. Evidence Acquisition
3. Evidence Synthesis
3.1. Large Vessel Vasculitides
3.1.1. Takayasu Arteritis (TA)
3.1.2. Giant Cell Arteritis (GCA)
3.2. Medium Vessel Vasculitides
3.2.1. Polyarteritis Nodosa (PAN)
3.2.2. Kawasaki Disease (KD)
3.3. Small Vessel Vasculitides
3.3.1. ANCA-associated Vasculitides
Granulomatosis with Polyangiitis (GPA)
Microscopic Polyangiitis (MPA)
Eosinophilic Granulomatosis with Polyangiitis (EGPA)
3.3.2. Small Vessels Vasculitides Associated with Immune Complex Deposition
Immunoglobulin A Vasculitis (IgAV)
Other Small Vessels Vasculitides Associated with Immune Complex Deposition
3.4. Variable Vessels Vasculitides
Behçet’s Disease (BD)
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Type | Main Symptoms | Urological Manifestations |
---|---|---|
Large Vessel Vasculitis | ||
Takayasu arteritis (TA) | Arthralgia, myalgia, carotidynia, absent or weak peripheral pulse, limb claudication, arterial bruit, discrepant blood pressure between arms, hypertension, angina, gastrointestinal symptoms (abdominal pain, diarrhea, gastrointestinal hemorrhage) skin lesions (erythema nodosum, pyoderma gangrenosum), respiratory symptoms (chest pain, dyspnea, hemoptysis, pulmonary hypertension), neurologic symptoms (light headedness, vertigo, syncope, orthostasis, headaches, convulsions, and strokes), visual impairment | Obstructive nephropathy |
Giant cell arteritis (GCA) | Jaw claudication, ocular symptoms (transient visual loss, permanent vision loss, diplopia, Charles Bonnet syndrome), musculoskeletal symptoms (proximal polyarthralgias and myalgias, peripheral synovitis, distal extremity swelling with pitting edema), large vessel involvement (aneurysms and dissections of the aorta, stenosis, occlusion, and ectasia of large arteries), strokes | Epididymitis, orchitis, testicular masses |
Medium Vessel Vasculitis | ||
Polyarteritis nodosa (PAN) | Skin lesions (tender erythematous nodules, purpura, livedo reticularis, ulcers, bullous or vesicular eruption), neurologic symptoms (mononeuropathy multiplexor asymmetric polyneuropathy affecting, e.g., radial, ulnar, peroneal nerves), gastrointestinal symptoms (abdominal pain, nausea, vomiting, melena, bloody or non-bloody diarrhea, life-threatening gastrointestinal bleeding), coronary artery disease (myocardial ischemia, heart failure, cardiomyopathy), myalgia and muscle weakness, ocular symptoms (ischemic retinopathy with hemorrhages, retinal detachment, ischemic optic neuropathy), glomerulonephritis | Orchitis, scrotal necrosis, bladder and testicular masses, ureteric stricture, spontaneous ureteric rupture, renal artery aneurysms, perirenal hematomas, spontaneous retroperitoneal hemorrhage |
Kawasaki disease (KD) | Conjunctivitis, mucositis, skin lesions (rash, perineal erythema, redness or crust formation at the site of Bacille Calmette–Guérin inoculation), extremity changes (indurated edema of the dorsum of their hands and feet, diffuse erythema of their palms and soles), arthritis, lymphadenopathy (cervical lymphadenopathy), cardiovascular involvement (coronary arteries inflammation, formation of microaneurysms, myocarditis, pericarditis, valvulitis) | Sterile pyuria, hydrocele testis |
Small Vessel Vasculitis | ||
Anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis | ||
Microscopic polyangiitis (MPA) | Elevated purpura, alveolar hemorrhage, glomerulonephritis | Prostatitis |
Granulomatosis with polyangiitis (GPA) | Upper airways, eye and ear disease (conductive hearing loss, sensorineural hearing loss, strawberry gingivitis, underlying bone destruction with loosening of teeth, non-specific ulcerations throughout the lining of the mouth and nasal septum), renal involvement (rapidly progressive glomerulonephritis), subglottal stenosis, lower respiratory tract involvement (pulmonary nodules, cavitary lesions, bleeding in the lungs, bronchial stenosis), arthritis, skin lesions (subcutaneous nodule on the elbow, purpura), neurologic symptoms: (sensory neuropathy, mononeuritis multiplex) | Prostatitis, epididymitis, orchitis, ureteric stricture, penile ulceration, necrotizing urethritis, large renal and bladder granulomas, vesicovaginal fistula |
Eosinophilic granulomatosis with polyangiitis (EGPA) | Respiratory symptoms (asthma, allergic rhinitis, nasal polyps, pulmonary bleeding), neurologic symptoms (mononeuropathy multiplex, symmetrical polyneuropathy), renal involvement (glomerulonephritis, hypertension), cardiovascular involvement (myocarditis, pericarditis), skin lesions (elevated purpura, subcutaneous nodules, livedo reticularis), gastrointestinal symptoms (eosinophilic gastroenteritis, diarrhea, gastrointestinal bleeding, colitis) | Prostatitis, cystitis, ureteric stricture, vesicovaginal fistula |
Immune complex small vessel vasculitides | ||
IgA vasculitis (IgAV) | Skin lesions (symmetrical erythematosus petechial or purpuric rash that almost exclusively starts on the lower limbs and buttocks), arthritis, gastrointestinal symptoms (nausea, vomiting, colicky abdominal pain, transient paralytic ileus, gastrointestinal hemorrhage, bowel ischemia and necrosis, intussusception, bowel perforation), glomerulonephritis | Epididymitis, orchitis, ureteric stricture, cystitis, priapism, spermatic vein thrombosis |
Variable Vessel Vasculitis | ||
Bechet’s disease (BD) | Oral ulcerations, skin lesions (acneiform lesions, papulo-vesiculo-pustular eruptions, pseudofolliculitis, nodules, erythema, palpable purpura), ocular disease (uveitis, secondary cataracta, glaucoma, macular edema), neurologic symptoms, arterial disease (hemorrhage, stenosis, aneurysm formation), venous thrombosis, cardiac disease, gastrointestinal symptoms (abdominal pain, diarrhea, gastrointestinal ulcerations, bleeding) | Genital ulceration, epididymitis, sterile urethritis, bladder wall ulceration, cystitis, vesicovaginal fistula, urethrovaginal fistula, priapism |
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Nowak, Ł.; Krajewski, W.; Krajewska, J.; Chorbińska, J.; Kiełb, P.; Małkiewicz, B.; Szydełko, T. Urological Manifestations of the Systemic Vasculitides—A Scoping Review. Uro 2021, 1, 209-221. https://doi.org/10.3390/uro1040023
Nowak Ł, Krajewski W, Krajewska J, Chorbińska J, Kiełb P, Małkiewicz B, Szydełko T. Urological Manifestations of the Systemic Vasculitides—A Scoping Review. Uro. 2021; 1(4):209-221. https://doi.org/10.3390/uro1040023
Chicago/Turabian StyleNowak, Łukasz, Wojciech Krajewski, Joanna Krajewska, Joanna Chorbińska, Paweł Kiełb, Bartosz Małkiewicz, and Tomasz Szydełko. 2021. "Urological Manifestations of the Systemic Vasculitides—A Scoping Review" Uro 1, no. 4: 209-221. https://doi.org/10.3390/uro1040023
APA StyleNowak, Ł., Krajewski, W., Krajewska, J., Chorbińska, J., Kiełb, P., Małkiewicz, B., & Szydełko, T. (2021). Urological Manifestations of the Systemic Vasculitides—A Scoping Review. Uro, 1(4), 209-221. https://doi.org/10.3390/uro1040023