IgG4-related prostatitis
Prostate involvement in IgG4-related disease.
Last updated
IgG4-related prostatitis is prostate involvement in men with IgG4-related disease (IgG4-RD), an emerging fibroinflammatory disease entity characterized by a tendency to mass forming lesions in multiple sites of the body and usually a prompt response to steroid therapy. Men with this condition may also present with manifestations of IgG4-RD at other sites, either synchronously or metachronously.
Quick Facts
- Field
- Urology
- Pathology
- Rheumatology
- Condition type
- Fibroinflammatory disease
- Key feature
- Mass forming lesions, response to steroids
- Common symptoms
- Lower urinary tract symptoms (dysuria, pollakisuria, urgency, incomplete emptying)
Facts from the source article.
Lore & Background
Several case studies on IgG4-related prostatitis have been reported. Patients commonly present with lower urinary tract symptoms such as dysuria, pollakisuria, urinary urgency, and a feeling of incomplete emptying.
The clinical presentation is similar to benign prostatic hyperplasia or chronic prostatitis, although pain does not usually appear to be significant. Diagnosis can be made from histological examination if prostate biopsy or surgery has been performed, with hallmark features including storiform fibrosis, dense lymphoplasmacytic infiltrate rich in IgG4-positive plasma cells, and obliterative phlebitis. However, identification depends on awareness of the condition, as special immunostaining is required.
Reader's Guide
IgG4-related prostatitis is significant as a manifestation of IgG4-related disease, an emerging entity that can mimic common prostatic conditions like benign prostatic hyperplasia or chronic prostatitis. Its recognition is important because it responds well to glucocorticoid therapy, provided advanced fibrotic lesions have not caused irreversible damage. Men given glucocorticoids for IgG4-RD at other sites sometimes report relief of lower urinary tract symptoms, suggesting underdiagnosis.
However, cases are likely to be misdiagnosed as benign prostatic hyperplasia and treated with alpha blockers, whose efficacy in this condition remains unclear. FDG-PET scans have been reported useful for detection. The condition highlights the need for awareness among urologists and pathologists to ensure proper diagnosis and treatment.
More in Steroid-responsive inflammatory conditions
Sources
Compiled from Wikipedia and the sources listed below. Text from Wikipedia is available under CC BY-SA 4.0; this entry is adapted from it.
- Wikipedia: IgG4-related prostatitis (CC BY-SA 4.0).
- Word definitions: the Codexery glossary, each quoted from its Wikipedia article.
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