SHM Converge Scientific Abstract ePoster Gallery-A Multi-System Approach to Diagnosis and Management of C-Anca Associated Vasculitis

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This poster describes a 50-year-old man with a smoking history and current vape use who presented with bilateral flank pain, chills, and dysuria. Two days earlier, he had been evaluated at urgent care for hematuria without infection and had an unremarkable CT abdomen/pelvis. He was also found to have right-sided conjunctivitis and was given lubricant drops. Additional symptoms included arthritic pain and a chronic dry cough.<br /><br />On exam, he had right conjunctivitis and mild suprapubic tenderness. Laboratory testing showed hematuria without infection, elevated inflammatory markers (CRP and ESR), and positive C-ANCA. CT chest revealed cavitary pulmonary nodules. A lung biopsy showed benign inflammatory tissue, while bronchoscopy confirmed diffuse alveolar hemorrhage. Based on multisystem involvement, the patient was diagnosed with C-ANCA-associated vasculitis, most consistent with granulomatosis with polyangiitis (GPA).<br /><br />He was treated aggressively with plasmapheresis and corticosteroids, with outpatient rituximab planned. The discussion highlights that ANCA-associated vasculitis is a small- to medium-vessel autoimmune disease that can affect the lungs, kidneys, and eyes, making diagnosis challenging. Pulmonary nodules and diffuse alveolar hemorrhage are serious manifestations, and renal disease may initially present only as microscopic hematuria with preserved creatinine.<br /><br />The poster concludes that early recognition of multisystem disease is essential, as prompt treatment with immunosuppression and plasmapheresis can prevent irreversible organ damage and improve outcomes.

Asset Subtitle

Kimia S. Taghaddos

Meta Tag

Author List Jean Carlo Medina, Kimia S. Taghaddos

Category Clinical Vignettes

Concept ANCA-Associated Vasculitis

Concept Granulomatosis with Polyangiitis

Concept Proteinase 3 ANCA

Concept Hematuria

Concept Renal involvement

Distinguished Non-Finalist

Presenter Organization St George's University

Presenting Author Kimia S. Taghaddos

Track Adult

Keywords

granulomatosis with polyangiitis

C-ANCA vasculitis

diffuse alveolar hemorrhage

cavitary pulmonary nodules

hematuria

conjunctivitis

plasmapheresis

corticosteroids

rituximab

autoimmune disease

ANCA-Associated Vasculitis

Granulomatosis with Polyangiitis

Proteinase 3 ANCA

Hematuria

Renal involvement