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Case Reports in Rheumatology
Volume 2014 (2014), Article ID 713957, 3 pages
http://dx.doi.org/10.1155/2014/713957
Case Report

A Case of Granulomatosis with Polyangiitis Causing Hydroureter and Hydronephrosis

1Internal Medicine, Mount Sinai School of Medicine, Queens Hospital Center, Jamaica, NY 11432, USA
2Mount Sinai School of Medicine, Queens Hospital Center, Jamaica, NY 11432, USA

Received 3 June 2013; Accepted 5 July 2013; Published 2 January 2014

Academic Editors: S. S. Koca and C. Pineda

Copyright © 2014 Farzin Farpour and Adriana Abrudescu. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Granulomatosis with Polyangiitis (GPA, formerly known as Wegener) is a systemic vasculitis characterized by granulomatous involving upper and lower respiratory tract and can also cause necrotizing glomerulonephritis (Umemoto et al. 2012 and Takala et al. 2011). GPA is associated with antineutrophil cytoplasmic autoantibodies (ANCA) against serine proteinase 3 (PR3) (Takala et al. 2011, Dufour et al. 2012, and Berthoux et al. 2011). This disease usually starts with involvement of the upper and lower respiratory tracts and also can involve kidney, eyes, skin, central and peripheral nervous systems, and gastrointestinal tract (Umemoto et al. 2012, Takala et al. 2011, and Berthoux et al. 2011). We describe a case of GPA that presented with abdominal pain. Computed tomography (CT) scan with contrast showed right sided moderate hydronephrosis and hydroureter, to the level of the right common iliac artery. There was also mural segmental thickening in common iliac artery which was thought to be the cause of the ureteral obstruction and hydronephrosis. Our case shows that mural segmental thickening in common iliac artery happened due to GPA and caused hydronephrosis. In addition, most of the cases with hydronephrosis due to GPA went through urology intervention such as stent placement but in our case hydronephrosis resolved with medical management.