Introduction:

Vasculitis associated with neutrophil cytoplasmic autoantibodies are infrequent conditions with a reported incidence of 46 to 184 cases per million people and it generally appears late in life.

Objective:

To describe the findings of a patient in whom microscopic polyangiitis-type pauciimmune vasculitis was late diagnosed.

Clinical case report:

We report a case of a 60-year-old patient with history of chronic kidney disease and respiratory compromise exhibited by dyspnea, productive cough, general malaise and fever. The images showed bronchiectasis and laboratory tests revealed high rheumatoid factor, positive perinuclear antineutrophil cytoplasmic autoantibodies, negative antinuclear antibodies, and bronchoalveolar lavage exposed hemosiderophages. Management with systemic corticosteroids was established with clear clinical improvement. However, an arteriovenous malformation that caused a hemorrhage in the posterior fossa caused his death.

Conclusions:

The diagnosis of vasculitis is complex and depends largely on clinical criteria, so physicians must be ready to interpret the clinical manifestations and paraclinical findings.

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