[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-411962-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-411962-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","granulomatosis-with-polyangiitis-presenting-with-h1n1-influenza-case-report","Granulomatosis With Polyangiitis Presenting With H1N1 Influenza - Case Report","","Granulomatosis with polyangiitis (GPA) is a rare ANCA-associated vasculitis causing necrotizing inflammation of small-to medium-sized vessels, most often involving the respiratory tract and kidneys. The case describes a 74-year-old man who developed H1N1 influenza followed by renal failure. Elevated PR3-ANCA and renal biopsy confirmed pauci-immune vasculitis consistent with GPA. Treatment required immunosuppression with corticosteroids and rituximab, underscoring careful assessment for autoimmune causes in unexplained pulmonary presentations.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/granulomatosis-with-polyangiitis-presenting-with-h1n1-influenza-case-report/411962/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/granulomatosis-with-polyangiitis-presenting-with-h1n1-influenza-case-report/411962.png","ImageObject",300,407,{"name":42,"@type":43},"Kurz","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",11,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What is the underlying diagnosis in this case?","Question",{"text":63,"@type":64},"The diagnosis is granulomatosis with polyangiitis (GPA), supported by elevated PR3-ANCA and renal biopsy showing pauci-immune vasculitis.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How did the patient initially present, and what complications developed?",{"text":68,"@type":64},"He presented with coryzal symptoms, haemoptysis, and chest pain, was found positive for H1N1 influenza, and later deteriorated with respiratory failure requiring ICU care before renal failure was recognized.",{"name":70,"@type":61,"acceptedAnswer":71},"What treatments were used after the GPA diagnosis?",{"text":72,"@type":64},"Management included immunosuppressive therapy with corticosteroids and rituximab, along with supportive care addressed to infection, heart failure, and atrial fibrillation.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},411962,1790736599,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":97,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145,"preview_page_count":4},2336478945635,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Review began 11/08/2025  \nReview ended 11/28/2025  \nPublished 12/02/2025  \n© Copyright 2025  \nRaza et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98284  \nOpen Access Case Report  \nGranulomatosis With Polyangiitis Presenting With H 1N 1 Influenza  \nAhmed Raza 1, Ahmed Algahiny 2  \n1. Pulmonology, University Hospitals of Leicester NHS Trust, Leicester, GBR 2. Internal Medicine, University Hospitals of Leicester NHS Trust, Leicester, GBR  \nCorresponding author: Ahmed Raza, [ahmed.raza11@nhs.net](ahmed.raza11@nhs.net)  \nAbstract  \nGranulomatosis with polyangiitis (GPA) is a rare antineutrophil cytoplasmic antibody (ANCA) associated vasculitis characterized by necrotizing inflammation of small-to medium-sized vessels, most commonly affecting the respiratory tract and kidneys. We report the case of a 74-year-old man who presented with H 1N 1 influenza infection followed by renal failure. Serologic testing revealed elevated PR3-ANCA, and renal biopsy confirmed a pauci-immune vasculitis consistent with a diagnosis of GPA requiring immunosuppressive therapy with corticosteroids and rituximab. This case highlights the necessity of a thorough evaluation for autoimmune aetiologies in patients presenting with unexplained pulmonary symptoms.  \nCategories: Nephrology, Pulmonology, Allergy/Immunology  \nKeywords: antineutrophil cytoplasmic antibody (anca), autoimmune vasculitis, granulomatosis with polyangiitis (gpa), h1n 1 influenza, organising pneumonia  \nIntroduction  \nGranulomatosis with polyangiitis (GPA), previously known as Wegener 's granulomatosis, is a necrotizing vasculitis that affects small to medium-sized blood vessels, leading to inflammation and tissue damage. It belongs to a group of rare autoimmune conditions collectively referred to as antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, which are characterized by inflammation of small to medium-sized vessels and present with a range of clinical manifestations [1] . The three main types of ANCA-associated vasculitis are GPA, microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss syndrome) [1] . Because GPA can involve several organs at once, its early symptoms are often non-specific and may resemble common illnesses. It commonly involves the respiratory tract, kidneys, nasal septum, and sinuses [2] . Renal involvement is seen in approximately 50% of patients at the time of diagnosis, typically presenting with reduced kidney function, proteinuria, and haematuria [3] . Respiratory features such as sinus pain, nasal congestion, cough, and general flu-like symptoms are common initial complaints. Untreated GPA can progress rapidly and cause permanent organ damage, so timely recognition is essential. We present a case of a patient who initially presented with symptoms suggestive of an upper respiratory tract infection and was diagnosed with H 1N 1. The patient subsequently deteriorated, required admission to the intensive care unit (ICU), and was eventually diagnosed with GPA.  \nCase Presentation  \nA 74-year-old Caucasian male presented with a one-week history of coryzal symptoms, haemoptysis, and chest pain. His past medical history includes hypertension, and he had a good baseline performance status (Eastern Cooperative Oncology Group 1), remaining fully active and cycling twice weekly. He was admitted to the ICU with low oxygen saturations and low Glasgow Coma Scale (GCS) requiring intubation, and was successfully decannulated after three days.  \nInitial investigations revealed markedly elevated inflammatory markers, including C-reactive protein and white cell count, suggesting a significant systemic inflammatory response. A bronchoalveolar lavage (BAL) was positive for H1N 1 influenza. Micro","cbCaivhyfQmi79e5","https://ap.wps.com/l/cbCaivhyfQmi79e5","pdf",2333986,"English","# Abstract\n# Introduction\n# Case Presentation\n## Initial presentation and investigations\n## Imaging and cardiac evaluation\n## Treatment and clinical course","[{\"question\":\"What is the underlying diagnosis in this case?\",\"answer\":\"The diagnosis is granulomatosis with polyangiitis (GPA), supported by elevated PR3-ANCA and renal biopsy showing pauci-immune vasculitis.\"},{\"question\":\"How did the patient initially present, and what complications developed?\",\"answer\":\"He presented with coryzal symptoms, haemoptysis, and chest pain, was found positive for H1N1 influenza, and later deteriorated with respiratory failure requiring ICU care before renal failure was recognized.\"},{\"question\":\"What treatments were used after the GPA diagnosis?\",\"answer\":\"Management included immunosuppressive therapy with corticosteroids and rituximab, along with supportive care addressed to infection, heart failure, and atrial fibrillation.\"}]","Granulomatosis With Polyangiitis Presenting With H1N1 Influenza - Case Report | PDF",1790590101,13]