Anti-proteinase 3 Antibody (PR3)-Anti-neutrophil Cytoplasmic Antibody (ANCA)-Positive Vasculitis: A Rare Presentation in a 90-Year-Old Female
Year: 2025
Type: article
Study design: Case Report
Abstract: Granulomatosis with polyangiitis (GPA), a rare systemic vasculitis, typically affects middle-aged adults, with incidence declining significantly in the elderly. Here, we present a rare and exceptional case of new-onset GPA in a 90-year-old female presenting with hemoptysis and characteristic systemic manifestations. Initially investigated for suspected lung malignancy due to her advancing age and history of non-Hodgkin's lymphoma (in remission since 2017), the patient was diagnosed with proteinase 3 (PR3) anti-neutrophil cytoplasmic antibody (ANCA)-positive vasculitis and characteristic imaging findings. Treatment with corticosteroids, immunosuppressants, and avacopan resulted in improved renal function and overall resolution of symptoms, highlighting the importance of considering vasculitis as a differential diagnosis in elderly patients with multisystem involvement. This case report features the diagnostic challenges and therapeutic considerations of late-onset GPA in the geriatric population.
Source: Cureus
DOI: 10.7759/cureus.97341
Authors: Sara Shehab, Hesham K Badr, Hammad Khan, Sohaib Eladl, Mohamed Taha
Institution: Blackpool Teaching Hospitals NHS Foundation Trust
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4416425827