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

• Published in: BMJ case reports Vol. 2018; p. bcr-2018-227161
• Main Authors: Aeddula, Narothama Reddy, Pathireddy, Samata, Ansari, Asif, Juran, Peter J
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 08-11-2018; BMJ Publishing Group
• Series: Case Report
• Subjects: Atrophy; Biopsy; Blood; Case reports; Diabetes; Edema; Gangrene; Gastrointestinal surgery; Heart failure; Hemodialysis; Hepatitis; Hypertension; Kidney cancer; Kidney diseases; Lupus; Neutrophils; Proteins; Rare Disease; acute renal failure; drug interactions; renal system; vasculitis
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2018-227161

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.