Focal Alveolar Hemorrhage Secondary to Hydralazine-Associated Antineutrophilic Cytoplasmic Antibody Vasculitis.

anca vasculitis focal alveolar hemorrhage hemoptysis hydralazine-associated vasculitis pulmonary capillaritis

Journal

Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737

Informations de publication

Date de publication:
Jul 2023
Historique:
accepted: 17 07 2023
medline: 19 7 2023
pubmed: 19 7 2023
entrez: 19 7 2023
Statut: epublish

Résumé

Hydralazine is rarely associated with antineutrophilic cytoplasmic antibody (ANCA) vasculitis. In the appropriate clinical scenario, such as in a patient with pulmonary, renal, or cutaneous manifestations, finding antibodies against nuclear and cytoplasmic neutrophil antigens may suggest drug-induced vasculitis after exposure to hydralazine. We present the case of an elderly man diagnosed with focal alveolar hemorrhage with elevated concentrations of anti-myeloperoxidase antibody, anti-proteinase-3 antibody, and antinuclear antibodies in the setting of prolonged hydralazine therapy. We observed a rapid clinical improvement with hydralazine discontinuation and systemic corticosteroids. We did not observe further disease activity while on mycophenolate mofetil six months later.

Identifiants

pubmed: 37465085
doi: 10.7759/cureus.42031
pmc: PMC10351746
doi:

Types de publication

Case Reports

Langues

eng

Pagination

e42031

Informations de copyright

Copyright © 2023, Martinez Manzano et al.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Jose M Martinez Manzano (JM)

Internal Medicine, Einstein Medical Center Philadelphia, Philadelphia, USA.

Simone A Jarrett (SA)

Internal Medicine, Einstein Medical Center Philadelphia, Philadelphia, USA.

Kevin Bryan Lo (KB)

Internal Medicine, Einstein Medical Center Philadelphia, Philadelphia, USA.

Mitali Sen (M)

Rheumatology, Einstein Medical Center Philadelphia, Philadelphia, USA.

Irene J Tan (IJ)

Rheumatology, Einstein Medical Center Philadelphia, Philadelphia, USA.

Classifications MeSH