Hydralazine-associated antineutrophil cytoplasmic antibody vasculitis with pulmonary-renal syndrome.

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Aeddula NR, Pathireddy S, Ansari A, Juran PJ

Hydralazine-associated antineutrophil cytoplasmic antibody vasculitis with pulmonary-renal syndrome.

BMJ Case Rep. 2018 Nov 8;2018. pii: bcr-2018-227161. doi: 10.1136/bcr-2018-227161.

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30413463 [ View in PubMed
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Abstract

Hydralazine, a vasodilator, is commonly used as an adjunctive treatment for moderate to severe hypertension, heart failure and hypertensive emergencies in pregnancy. Hydralazine-induced lupus was first described in 1953. Clinical presentation ranges from arthralgia, myalgia, petechiae, or rash to single or multiorgan involvement. An occurrence of systemic vasculitis is a rare complication. When presented as the pulmonary-renal syndrome, it could have a rapidly progressive course which can be fatal. Here, we describe a case of hydralazine-associated rapidly progressive glomerulonephritis and pulmonary haemorrhage. We use this case to review the current literature and discuss and highlight the importance of a high degree of clinical acumen, early diagnosis and prompt treatment for better clinical outcomes.

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