Resumen

HERNANDEZ NAVAS, Jorge Andrés et al. Granulomatosis with polyangiitis: an atypical presentation of a complex vasculitic disease. Rev. virtual Soc. Parag. Med. Int. [online]. 2025, vol.12, n.1, e12142509.  Epub 30-Abr-2025. ISSN 2312-3893.  https://doi.org/10.18004/rvspmi/2312-3893/2025.e12142509.

Granulomatosis with polyangiitis (GPA) is a systemic vasculitis that mainly affects small and medium-sized vessels, with clinical manifestations including pulmonary involvement. The lungs are one of the most involved organs, and typical lesions include cavitary nodules, infiltrates, and alveolar hemorrhage. Early diagnosis and proper management are essential to avoid serious complications.

We present the case of a 51-year-old female patient with a history of rheumatoid arthritis, fibromyalgia, Sjögren's syndrome, arterial hypertension, and latent tuberculosis. She presented with headache, polyuria, asthenia, and neuropsychiatric symptoms. A pituitary adenoma was identified by MRI and a cavitated lung lesion, possibly due to fungal superinfection or sequelae of tuberculosis. Hormonal profile showed hypothyroidism and adrenal insufficiency. The antineutrophil cytoplasmic antibodies (c-ANCA) result was 1:320. She received treatment with hydrocortisone, levothyroxine, desmopressin, and cyclophosphamide. The patient showed significant improvement, and outpatient follow-up with endocrinology and rheumatology was planned for therapeutic adjustments and control of comorbidities.

Palabras clave : vasculitis; antineutrophil cytoplasmic antibody-associated vasculitis; granulomatosis with polyangiitis.

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