Microscopic polyangiitis, an onset with diffuse alveolar hemorrhage

Abstract

Introduction: antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis is a group of complex chronic diseases that cause morbidity, systemic organ damage, therapeutic overload, and risk of relapse. Microscopic polyangiitis (MPA) primarily affects small vessels in the lungs and kidneys, characterized by inflammation that can lead to necrosis of blood vessels, presence of ANCA in the bloodstream, and absence of necrotizing inflammation of the parenchyma in histopathology. Methods: we present the case of a 58-year-old female patient with hemoptysis, fever, and dyspnea. Results: laboratory tests show anemia, leukocytosis, positive p-ANCA, hematuria, and proteinuria. The CT scan reveals areas of increased attenuation with a ground-glass pattern and centrilobular nodular opacities occupying the middle lobe and both lower lobes. The patient also tested positive for MPO-ANCA, leading to the diagnosis of ANCA-positive vasculitis, specifically microscopic polyangiitis with pulmonary and renal involvement, pneumonia, and renal insufficiency. She received appropriate medical treatment, resulting in adequate resolution. Conclusions: microscopic polyangiitis requires interdisciplinary management, which, along with radiological findings, contributes to the early diagnosis and timely treatment of the pathology