Polyarteritis nodosa presenting with frank hematuria
Polyarteritis nodosa (PAN) is an uncommon systemic vasculitischaracterized by necrotizing inflammation of small- or mediumsizedarteries. The disease normally presents with non-specificsymptoms. Urological symptoms at presentation are extremely rare.We report a 65-year-old man who was diagnosed with a polyarteritisnodosa having presented atypically with left testicular pain andswelling, and an intratesticular lesion. He developed painless visiblehematuria while under investigation. No gross arterio-venousfistula was seen to suggest a false aneurysm. Subsequently, laboratorystudies showed positive anti-neutrophil cytoplasmic antibodylevels and a raised erythrocyte sedimentation rate. This was anunusual presentation of PAN diagnosed with multidisciplinaryinput from the urology, radiology and nephrology teams.