Good response to rituximab in a patient with granulomatosis with polyangiitis and pulmonary, renal manifestations and ophthalmoplegia.

Cyclophosphamide (CYC) is a classical drug for the treatment of severe granulomatosis with polyangiitis (GPA). However, a considerable number of patients are resistant to standard treatment and it can show substantial toxicity. Therefore, alternative agents should be considered in refractory cases.