PT  - JOURNAL ARTICLE
AU  - Mustafa Sowida
TI  - Granulomatosis polyangiitis
AID  - 10.1136/bcr-2018-228693
DP  - 2019 Jul 01
TA  - BMJ Case Reports
PG  - e228693
VI  - 12
IP  - 7
4099  - http://casereports.bmj.com/content/12/7/e228693.short
4100  - http://casereports.bmj.com/content/12/7/e228693.full
SO  - BMJ Case Reports2019 Jul 01; 12
AB  - A 22-year-old female patient was admitted to hospital after being referred from the oral medicine clinic where she had been seen for persistent gingivitis and mouth ulcers. She described an insidious history of persistent fevers, dry cough and unexplained weight loss over 4–6 weeks. Imaging showed extensive bilateral pulmonary nodules with mediastinal lymphadenopathy and two lesions in the pancreas. MRI revealed these lesions to be well-defined fluid-filled cysts in the tail of the pancreas, without features of malignancy. Core biopsies taken from her lung nodules demonstrated features of vasculitis with granulomata. This was consistent with her positive immunology for c-antinuclear cytoplasmic antibodies and proteinase-3, which were sent after her fever failed to settle with antibiotic treatment. In keeping with a diagnosis of vasculitis, the patient showed a significant clinical and biochemical response to intravenous methylprednisolone and high-dose daily prednisolone thereafter.