Diagnostic dilemma: drug-induced vasculitis versus systemic vasculitis Article Swipe

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Vasculitis Medicine Systemic vasculitis Anti-neutrophil cytoplasmic antibody Pathology Pathological Rapidly progressive glomerulonephritis Biopsy Disease

Indira Acharya , David Weisman , Lanaya Williams Smith , Lois J. Arend ·

YOU? · · 2023 · Open Access · · DOI: https://doi.org/10.1136/bcr-2023-254736 · OA: W4383872737

Drug-induced vasculitis can rarely cause inflammation and necrosis of blood vessel walls of both kidney and lung tissue. Diagnosis is challenging because of the lack of difference between systemic and drug-induced vasculitis in clinical presentation, immunological workup and pathological findings. Tissue biopsy guides diagnosis and treatment. Pathological findings must be correlated with clinical information to arrive at a presumed diagnosis of drug-induced vasculitis. We present a patient with hydralazine-induced antineutrophil cytoplasmic antibodies-positive vasculitis with a pulmonary-renal syndrome manifesting as pauci-immune glomerulonephritis and alveolar haemorrhage.