Multidisciplinary management of a Spondyloarthritis presenting with bladder involvement as the initial clinical symptom: a rare case report
Abstract Background Spondyloarthritis (SpA) is a group of chronic inflammatory rheumatic diseases that can present with diverse extra-articular manifestations. However, bladder involvement as the primary clinical presentation has not been previously reported. Case presentation : We present a case re...
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BMC
2025-04-01
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| Online Access: | https://doi.org/10.1186/s12894-025-01796-6 |
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| author | Lingmin Song Shengdong Li Jingjing Yu Guobin Weng |
| author_facet | Lingmin Song Shengdong Li Jingjing Yu Guobin Weng |
| author_sort | Lingmin Song |
| collection | DOAJ |
| description | Abstract Background Spondyloarthritis (SpA) is a group of chronic inflammatory rheumatic diseases that can present with diverse extra-articular manifestations. However, bladder involvement as the primary clinical presentation has not been previously reported. Case presentation : We present a case report of a 55-year-old male with a 20-year history of recurrent left lower abdominal pain and lower urinary tract symptoms (LUTS). Despite multiple treatments for presumed chronic prostatitis and cystitis, symptoms persisted. Imaging revealed bladder wall alterations and inflammatory changes in bilateral sacroiliac joints. Laboratory tests showed positive HLA-B27 expression. Histopathological examination of bladder tissue demonstrated chronic inflammation with eosinophilic infiltration and vasculitis. These findings led to a diagnosis of SpA, despite the absence of typical musculoskeletal symptoms. Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) and tumor necrosis factor (TNF) inhibitors resulted in complete resolution of urological symptoms and normalization of bladder morphology. After one month of continuous management, the patient experienced significant relief from left lower abdominal pain (NRS 2–3) and LUTS. The patient reported complete alleviation of pain (NRS 0) and LUTS at the three-month follow-up. No recurrence was observed during a 1-year follow-up period. Conclusions This case highlights the potential for SpA to manifest primarily with urological symptoms, emphasizing the need for clinicians to consider systemic inflammatory conditions in cases of refractory LUTS. The successful diagnosis and management underscore the importance of interdisciplinary collaboration between urology and rheumatology. |
| format | Article |
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| institution | Kabale University |
| issn | 1471-2490 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
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| spelling | doaj-art-1cbc7e5afff746bdae3fc9f5b56a1be52025-08-20T03:52:24ZengBMCBMC Urology1471-24902025-04-012511610.1186/s12894-025-01796-6Multidisciplinary management of a Spondyloarthritis presenting with bladder involvement as the initial clinical symptom: a rare case reportLingmin Song0Shengdong Li1Jingjing Yu2Guobin Weng3Department of Urologic SurgeryDepartment of Rheumatology and ImmunologyDepartment of PathologyDepartment of Urologic SurgeryAbstract Background Spondyloarthritis (SpA) is a group of chronic inflammatory rheumatic diseases that can present with diverse extra-articular manifestations. However, bladder involvement as the primary clinical presentation has not been previously reported. Case presentation : We present a case report of a 55-year-old male with a 20-year history of recurrent left lower abdominal pain and lower urinary tract symptoms (LUTS). Despite multiple treatments for presumed chronic prostatitis and cystitis, symptoms persisted. Imaging revealed bladder wall alterations and inflammatory changes in bilateral sacroiliac joints. Laboratory tests showed positive HLA-B27 expression. Histopathological examination of bladder tissue demonstrated chronic inflammation with eosinophilic infiltration and vasculitis. These findings led to a diagnosis of SpA, despite the absence of typical musculoskeletal symptoms. Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) and tumor necrosis factor (TNF) inhibitors resulted in complete resolution of urological symptoms and normalization of bladder morphology. After one month of continuous management, the patient experienced significant relief from left lower abdominal pain (NRS 2–3) and LUTS. The patient reported complete alleviation of pain (NRS 0) and LUTS at the three-month follow-up. No recurrence was observed during a 1-year follow-up period. Conclusions This case highlights the potential for SpA to manifest primarily with urological symptoms, emphasizing the need for clinicians to consider systemic inflammatory conditions in cases of refractory LUTS. The successful diagnosis and management underscore the importance of interdisciplinary collaboration between urology and rheumatology.https://doi.org/10.1186/s12894-025-01796-6SpondyloarthritisLower urinary tract symptomsBladder inflammationChronic pelvic painExtra-articular manifestationsMultidisciplinary approach |
| spellingShingle | Lingmin Song Shengdong Li Jingjing Yu Guobin Weng Multidisciplinary management of a Spondyloarthritis presenting with bladder involvement as the initial clinical symptom: a rare case report BMC Urology Spondyloarthritis Lower urinary tract symptoms Bladder inflammation Chronic pelvic pain Extra-articular manifestations Multidisciplinary approach |
| title | Multidisciplinary management of a Spondyloarthritis presenting with bladder involvement as the initial clinical symptom: a rare case report |
| title_full | Multidisciplinary management of a Spondyloarthritis presenting with bladder involvement as the initial clinical symptom: a rare case report |
| title_fullStr | Multidisciplinary management of a Spondyloarthritis presenting with bladder involvement as the initial clinical symptom: a rare case report |
| title_full_unstemmed | Multidisciplinary management of a Spondyloarthritis presenting with bladder involvement as the initial clinical symptom: a rare case report |
| title_short | Multidisciplinary management of a Spondyloarthritis presenting with bladder involvement as the initial clinical symptom: a rare case report |
| title_sort | multidisciplinary management of a spondyloarthritis presenting with bladder involvement as the initial clinical symptom a rare case report |
| topic | Spondyloarthritis Lower urinary tract symptoms Bladder inflammation Chronic pelvic pain Extra-articular manifestations Multidisciplinary approach |
| url | https://doi.org/10.1186/s12894-025-01796-6 |
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