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High PSA, ESR, large prostate with LUTS, loss of bone and muscle mass. History of herpes zoster. Recommendations?

Please ask the specialists among you what are the most likely diagnoses in a 67yo WM with a PSA of 11, %fPSA of 24%, normal CBC and diff, but a very high ESR 140 mm/hr and normal CRP , normal protein electrophoresis, normal DSDNA but mildly positive ANA. He also has a very large prostate (175 cc by transabd ultrasound) with attendant LUTS, a normal (dipstick) urinalysis , stable body weight but loss of bone and muscle mass with occasional scattered fasciculations. He has never had a prostate biopsy or bone scan. Two years ago he developed a circumorbital (around left eye) skin rash clinically diagnosed as Herpes Zoster which faded after two weeks of anti-herpetic pills. What are your best bets and recommendations? Thanks for any help, JE YYYY@YYYY
Asked On : Thu, 24 Jan 2013
Answers:  1 Views:  80
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Rheumatologist 's  Response
Dear Sir ,

Kindly get him evaluated for BPH , prostate malignancy and secondarily autoimmune disorders .

Dr. Shruti
Answered: Mon, 30 Dec 2013
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