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16 May 2021: Articles

Hydralazine-Induced Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: Asymptomatic and Renal-Restricted Presentation

Challenging differential diagnosis, Unusual setting of medical care, Rare disease, Adverse events of drug therapy

Wan Tu A* , Barry Fayman A* , Stephen C. Ward B , Yusufal Mamoon A , Sabiha S. Bandagi C

DOI: 10.12659/AJCR.931263

Am J Case Rep 2021; 22:e931263

Table 1. The patient’s serology results.

TestTiter/unitReference rangeResult
Antinuclear antibody (ANA)1: 2560 (IFA homogeneous pattern)Positive
Anti-double stranded DNA (dsDNA)EIA 89 IU/mLEIA ≤29 IU/mLPositive
Anti-Smith antibodyENAENA ≤0.9 AINegative
Anti-ribonuclear protein (RNP) antibodyENA 0.3 AIENA ≤0.9 AINegative
Anti-chromatin antibody2.4 AI≤0.9 AIPositive
Total complement, ch5067 U/mL42–95 U/mLNormal
Complement component C3 (C3)136 mg/dL81–157 mg/dLNormal
Complement component C4 (C4)26 mg/dL13–39 mg/dLNormal
Cytoplasmic antineutrophil cytoplasmic antibody (cANCA)NegativeNegative
Perinuclear antineutrophil cytoplasmic antibody (pANCA)>1: 1280NegativePositive
Atypical anti-neutrophilic cytoplasmic antibodyNegativeNegative
Anti-proteinase 3 (PR3) antibody132.2 U≤20.0 UPositive
Anti-myeloperoxidase (MPO) antibody104.0 U≤20.0 UPositive
Rheumatoid factor0–13 IU/mLNegative
Anti-cyclic citrullinated peptide (CCP) antibody≤19 UNegative
Anti-centromere antibody≤0.9 AINegative
Anti-histone antibody3.2 U0.0–0.9 UPositive
Anti-cardiolipin antibodyNegativePositive
Anti-scleroderma (scl70) antibody≤0.9 AINegative
Immunoglobulin G (IgG)1581 mg/dL610–1660 mg/dLNormal
Immunoglobulin M (IgM)155 mg/dL35–242 mg/dLNormal
Beta 2 glycoprotein 1 IgG Ab5.1 SGU≤20.0 SGUNegative
Beta 2 glycoprotein 1 IgM Ab31.1 SMU≤20.0 SMUPositive
Anti-glomerular basement membrane (GBM) antibody30–20Negative
EIA – enzyme immunoassay; ENA – epithelial cell-derived neutrophil attractant; IFA – indirect immunofluorescence assay.

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923