Clinical case of anca-associated vasculitis (granulomatosis with polyangiitis) with multisystem involvement

Chernylovskyi, A.V. (2025) Clinical case of anca-associated vasculitis (granulomatosis with polyangiitis) with multisystem involvement. Prospects and innovations of science, 51 (5). pp. 2453-2460. ISSN 2786-4952

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Abstract

This article presents a clinical case of ANCA-associated vasculitis, specifically granulomatosis with polyangiitis (GPA), in a 73-year-old female patient with multisystem involvement. The disease was initially masked as isolated ENT pathology (otitis, sinusitis), leading to significant delays in diagnosis. The clinicalpicture gradually worsened, with the onset of systemic symptoms includinganaemia, weight loss, ophthalmic disturbances, respiratory symptoms, and signs ofrenal syndrome. The final diagnosis of granulomatosis with polyangiitis, with highdisease activity (as assessed by the BVAS scale), renal, ocular, upper respiratorytract, and haematological involvement, was established only after confirmation ofhigh PR3-ANCA levels and exclusion of haematological pathology. The patient washospitalised during the high-activity phase of the disease, with critically reducedglomerular filtration rate (GFR of 13 mL/min), significantly elevated C-reactiveprotein levels, haematuria, and proteinuria. Immunosuppressive therapy accordingto European guidelines (EULAR, KDIGO) was initiated, including pulse therapywith methylprednisolone, followed by maintenance doses of prednisolone incombination with azathioprine. This approach resulted in a positive clinicaloutcome: areduction in creatinine levels, normalisation of inflammatory markers,partial recovery of renal function, and improvement in the patient's generalcondition. The described case highlights the typical clinical heterogeneity of ANCA associated vasculitis and the challenges of early diagnosis, particularly in elderlypatients with nonspecific manifestations. The successful stabilization of the patientwithout the need for dialysis underscores the effectiveness of timely treatmentinitiation and the importance of a multidisciplinary approach involving nephrologists, rheumatologists, ophthalmologists, and ENT specialists. The article emphasises the importance of early ANCA testing, comprehensive clinicallaboratoryassessment, and dynamic monitoring to improve the prognosis in ANCA associated vasculitis.

Item Type:	Article
Additional Information:	DOI: 10.52058/2786-4952-2025-5(51)-2453-2460
Uncontrolled Keywords:	ANCA-associated vasculitis, granulomatosis with polyangiitis, PR3-ANCA, multisystem involvement, renal failure, conjunctivitis, immunosuppressive therapy, glucocorticoids
Subjects:	Nephrology
Divisions:	Departments > Department of Internal Medicine
Depositing User:	Аліна Чеботарьова
Date Deposited:	06 Jun 2025 11:18
Last Modified:	06 Jun 2025 11:18
URI:	http://repo.dma.dp.ua/id/eprint/9447

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