Granulomatosis with Polyangiitis: Recurrence or Treatment Consequences?
  • Andreia Diegues
    Internal Medicine Department, Unidade Local de Saúde do Nordeste, Portugal
  • Joana Tavares
    Nephrology Department, Centro Hospitalar Universitário do Porto, Portugal
  • Diogo Sá
    athological Anatomy Department, Centro Hospitalar Universitário do Porto, Portugal
  • João Oliveira
    Nephrology Department, Centro Hospitalar Universitário do Porto, Portugal
  • Diana Fernandes
    Internal Medicine Department, Unidade Local de Saúde do Nordeste, Portugal
  • Josefina Santos
    Nephrology Department, Centro Hospitalar Universitário do Porto, Portugal
  • Guillerme Rocha
    Nephrology Department, Centro Hospitalar Universitário do Porto, Portugal

Keywords

ANCA-PR3-associated vasculitis, granulomatosis with polyangiitis, intracranial hypertension, lung nodules

Abstract

Granulomatosis with polyangiitis (GPA) is the most common antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). We describe the case of a 38-year-old woman with relapsing GPA who presented with intracranial hypertension, followed by the appearance of cavitated lung nodules despite treatment with azathioprine. Clinical improvement and ANCA titre reduction were observed after rituximab treatment. We report a rare form of GPA relapse and highlight the challenge of following-up patients with GPA, in whom can be hard to distinguish relapse from the consequences of long-term immunosuppression.

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References

  • Yates M, Watts RA, Bajema IM, Cid MC, Crestani B, Hauser T, et al. EULAR/ERA-EDTA recommendations for the management of ANCA-associated vasculitis. Ann Rheum Dis 2016;75(9):1583–1594.
  • Wallace ZS, Miloslavsky EM. Management of ANCA associated vasculitis. BMJ 2020;368March):1–16.
  • Geetha D, Jefferson JA. ANCA-associated vasculitis: core curriculum 2020. Am J Kidney Dis 2020;75(1):124–137.
  • Arnaoutoglou MA, Xerras CG, Kalevrosoglou IK, Rafailidis VD, Notas KP, Tegos TI. Headache linked to intracranial hypertension and hypertrophic pachymeningitis as the initial and dominant presentation of granulomatosis with polyangiitis. Case report and review of the recent literature. Headache 2018;58(4):589–595.
  • Feragalli B, Mantini C, Sperandeo M, Galluzzo M, Belcaro G, Tartaro A, et al. The lung in systemic vasculitis: radiological patterns and differential diagnosis. Br J Radiol 2016;89(1061):20150992.
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    Published: 2021-04-22
    Issue: 2021: Vol 8 No 4 (view)


    How to cite:
    1.
    Diegues A, Tavares J, Sá D, Oliveira J, Fernandes D, Santos J, Rocha G. Granulomatosis with Polyangiitis: Recurrence or Treatment Consequences?. EJCRIM 2021;8 doi:10.12890/2021_002448.

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