Title:Hydralazine-Induced ANCA Associated Vasculitis (AAV) Presenting with Pulmonary-Renal Syndrome (PRS): A Case Report with Literature Review
Volume: 17
Issue: 2
Author(s): Karim Doughem*, Ayman Battisha, Omar Sheikh, Lakshmi Konduru, Bader Madoukh, Mohammed Al-Sadawi and Shakil Shaikh
Affiliation:
- University of Texas Health Science Center at Houston, Houston, TX 77030,United States
Keywords:
Hydralazine, vasculitis, pulmonary hemorrhage, hypertension, heart failure, pulmonary-renal syndrome.
Abstract: Hydralazine, an arterial vasodilator, is a widely used medication for the management of
hypertension and heart failure, especially for patients who cannot tolerate the use of ACEIs or
ARBs. It is generally well-tolerated and has a safe profile in pregnancy. However, hydralazine can
induce immune-mediated side effects, such as hydralazine-induced lupus and less commonly hydralazine-
induced ANCA vasculitis. The latter most commonly affects the kidneys with or without
other organ involvement. There are several cases reported in the literature of hydralazine-induced
ANCA associated vasculitis (AAV) that have pulmonary manifestations, also known as hydralazine-
induced pulmonary-renal syndrome (PRS), a condition with a high risk of mortality. We are
reporting a case of Hydralazine-induced ANCA associated glomerulonephritis with severe diffuse
alveolar hemorrhage (DAH). In addition, we will review the current literature and discuss the importance
of prompt diagnosis and early management to decrease mortality and morbidity associated
with this serious condition.
