Granulomatosis con poliangeítis: reporte de caso

Abstract

Introduction: Granulomatosis with Polyangiitis (GPA) is an autoimmune disease that belongs to the vasculitides associated with antineutrophil cytoplasmic antibodies (ANCA), which produce damage to the level of blood vessels. Its clinical presentation is complex and mainly affects the pulmonary and renal systems; its diagnosis is difficult; therefore, its management may be inadequate. The case of a 55-year-old female patient with GPA is reported, focusing on the clinical manifestations, diagnostic methods, and treatment regimen applied. Relevant findings: Presence of: sinusitis, cough with expectoration, dyspnea, pulmonary damage confirmed by computed axial tomography, and renal damage identified through laboratory tests and renal biopsy. Definitive diagnosis, therapeutic interventions, and results: The definitive diagnosis was reached through immunological tests, specifically ANCA testing, which reported high levels of anti-PR3 antibodies that are specific to GPA. For the management of the patient, an immunosuppressive regimen of cyclophosphamide and prednisone was initiated; however, due to observed adverse effects, it was decided to change the regimen to rituximab and mycophenolate mofetil, the doses were adjusted, taking into account the patient’s comorbidities. Conclusion: The importance of this case lies in the complex clinical presentation of the pathology, in addition to the diagnostic challenges and the importance of establishing an action plan according to the patient’s needs, identifying the severity of the multisystemic condition, and evaluating the underlying comorbidities.