Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 6, 2021; 9(10): 2344-2351
Published online Apr 6, 2021. doi: 10.12998/wjcc.v9.i10.2344
Granulomatosis with polyangiitis presenting as high fever with diffuse alveolar hemorrhage and otitis media: A case report
Xiao-Jie Li, Liu Yang, Xiao-Feng Yan, Chu-Ting Zhan, Jiang-Hua Liu
Xiao-Jie Li, Liu Yang, Xiao-Feng Yan, Chu-Ting Zhan, Jiang-Hua Liu, Department of General Practice, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530007, Guangxi Zhuang Autonomous Region, China
Jiang-Hua Liu, Department of General Practice, General Practice School of Guangxi Medical University, Nanning 530007, Guangxi Zhuang Autonomous Region, China
Author contributions: Liu JH and Yang L conducted the studies, participated in collecting the data, and drafted the manuscript; Yan XF and Zhan CT participated in the study design and performed the statistical analyses; Liu JH and Li XJ participated in the acquisition, analysis, or interpretation of data and drafted the manuscript; All authors read and approved the final manuscript.
Informed consent statement: Inform written consent was obtained from the patient for publication of this report and accompanying images.
Conflict-of-interest statement: All authors have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jiang-Hua Liu, MD, Doctor, Department of General Practice, The Second Affiliated Hospital of Guangxi Medical University, No. 166 East University Road, Nanning 530007, Guangxi Zhuang Autonomous Region, China. jianghualiu0107@163.com
Received: October 27, 2020
Peer-review started: October 27, 2020
First decision: November 20, 2020
Revised: December 3, 2020
Accepted: February 11, 2021
Article in press: February 11, 2021
Published online: April 6, 2021
Processing time: 154 Days and 2.3 Hours
Abstract
BACKGROUND

Granulomatosis with polyangiitis is a necrotizing inflammation of small and medium-sized vessels accompanied by formation of granuloma, involvement of primary granulomatous upper and lower respiratory tracts, glomerulonephritis, and vasculitis of small vessels.

CASE SUMMARY

Herein, we described a case of a 52-year-old man admitted with pulmonary nodules and high fever. Autoantibody workup revealed that the patient was positive for c-anti-neutrophil cytoplasmic antibodies and proteinase-3 anti-neutrophil cytoplasmic antibodies. Pulmonary biopsies revealed a local granulomatous structure. The patient received therapy with methylprednisolone and intravenous immunoglobulin, and his clinical symptoms improved.

CONCLUSION

Intravenous immunoglobulin may act on granulomatosis with polyangiitis similar to immunosuppressants.

Keywords: Granulomatosis with polyangiitis; Diffuse alveolar hemorrhage; Otitis media; Methylprednisolone; Intravenous immunoglobulin; Case report

Core Tip: By reviewing a patient diagnosed with granulomatosis with polyangiitis, we found that intravenous immunoglobin combined with methylprednisolone can reduce the symptoms of pulmonary hemorrhage. These findings differ from previous reports, and provide more possibilities for the treatment of similar conditions.