Hydralazine is a commonly used blood pressure medication that has been associated with rheumatologic manifestations such as drug-induced lupus. However, it is rarely associated with antineutrophilic cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV). Here we present a case of a 72-year-old female with hemoptysis, dyspnea, and palpable purpura, ultimately diagnosed with hydralazine-induced AAV. The diagnosis was proven via skin biopsy and serologic markers. A bronchoscopy revealed an alveolar hemorrhage. Treatment involved discontinuing hydralazine as well as steroids and rituximab. This case was atypical due to the relative lack of renal involvement. We also emphasize the importance of recognizing this rare diagnosis and discuss guideline-directed medical therapy for managing this condition.
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| http://dx.doi.org/10.7759/cureus.76967 | DOI Listing |
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