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Hydralazine-associated antineutrophil cytoplasmic antibody vasculitis with pulmonary–renal syndrome
  1. Narothama Reddy Aeddula1,2,
  2. Samata Pathireddy3,4,
  3. Asif Ansari5,
  4. Peter J Juran1,2
  1. 1Nephrology, Deaconess Health System, Evansville, Indiana, USA
  2. 2Medicine, Indiana University School of Medicine, Evansville, Indiana, USA
  3. 3Internal Medicine, Deaconess Health System, Evansville, Indiana, USA
  4. 4Medicine, Indiana University School of Medicine, Evansville, Indiana, USA
  5. 5Nephrology, Permian Basin Kidney Center, Midland, Texas, USA
  1. Correspondence to Dr Samata Pathireddy, drspathireddy{at}


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.

  • drug interactions
  • renal system
  • acute renal failure
  • vasculitis

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  • Contributors NRA, SP, AA and PJJ involved in the planning, conception, acquisition of data and helped with the final drafting of the case report. SP and NRA are the first authors and have equally contributed to the majority of the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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