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An elderly man developed hemoptysis, cough, fever, joint pain, and fatigue, was initially treated as pneumonia, then worsened with hypoxia and signs of alveolar hemorrhage. Serology with c-ANCA and supportive clinical findings supported GPA. High-dose corticosteroids were started promptly, followed by rituximab, producing significant improvement and discharge, with close follow-up to reduce morbidity and mortality.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/lung-limited-granulomatosis-with-polyangiitis-and-the-importance-of-early-treatment-a-case-report/435693/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/lung-limited-granulomatosis-with-polyangiitis-and-the-importance-of-early-treatment-a-case-report/435693.png","ImageObject",300,407,{"name":92,"@type":93},"CatatanPagi","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-04","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What symptoms did the 58-year-old patient present with, and how was the initial diagnosis handled?","Question",{"text":113,"@type":114},"He presented with hemoptysis, cough, fever, joint pain, and fatigue. He was initially diagnosed with pneumonia, then later identified as having GPA when symptoms persisted or recurred with supportive serology.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What diagnostic marker supported GPA in this case?",{"text":118,"@type":114},"Positive cytoplasmic antineutrophil cytoplasmic antibodies (c-ANCA) supported granulomatosis with polyangiitis alongside clinical findings.",{"name":120,"@type":111,"acceptedAnswer":121},"How was treatment managed, and what was the outcome?",{"text":122,"@type":114},"High-dose corticosteroids were initiated due to hypoxia and alveolar hemorrhage, followed by rituximab. The patient improved significantly, was discharged, and continued close follow-up.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},435693,1790736537,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},962090894170,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Case Report  \nLung-limited granulomatosis with polyangiitis and the importance of early treatment: a case report  \nHanaen Hamed, MDa , Sultaneh Haddad, MDb,c , LaithAlabd, MDa , Hiba Sharaf Eddin, MDa , Zakaria Alhmada, MDd , Rayan Elsadig, MDe , George Michael Kabbabe, MDf ,*, Nawar Albraday, MDa  \nIntroduction and importance: Granulomatosis with polyangiitis (GPA) is a rare systemic vasculitis causing necrotizing granulomatous inflammation, mostly affecting the respiratory tract and kidneys. It has an annual incidence of 0.3 to 1.4 per 100 000. Diagnosis is based on clinical presentation and serological findings. Treatment typically involves glucocorticoids and cyclophosphamide. This article describes a case of GPA in an elderly male with cough, hemoptysis, and bilateral hearing loss.  \nCase Presentation: A 58-year-old man presented with hemoptysis, cough, fever, joint pain, and fatigue. Initially diagnosed with pneumonia, he showed improvements with prednisolone but experienced recurring symptoms. Examination revealed abnormal CBC, proteinuria, and positive cytoplasmic antineutrophil cytoplasmic antibodies (c-ANCA), indicating granulomatosis with polyangiitis. Due to hypoxia and alveolar hemorrhage, high-dose corticosteroid therapy was initiated, followed by rituximab, leading to significant improvement.  \nClinical Discussion: Granulomatosis with polyangiitis (GPA) is a rare autoimmune disease primarily affecting the upper respiratory tract, lungs, and kidneys. The disease’s main inflammatory marker is c-ANCA. Treatment often involves steroids and immunosuppressants. This case emphasizes the necessity of early treatment, even without histological confirmation, due to severe symptoms like hemoptysis, hypoxia, and alveolar hemorrhage, but without renal involvement.  \nConclusion: Although GPA is systemic, it often appears in a limited form, affecting the respiratory system. While diagnosis requires a tissue biopsy, treatment should begin upon suspicion, especially in remote areas, to reduce morbidity and mortality and improve outcomes, which is the main purpose of working on this paper.  \nKeywords: diffuse alveolar hemorrhage, GPA, granulomatosis with polyangiitis, vasculitis  \nIntroduction  \nGranulomatosis with polyangiitis (GPA) is a systemic vasculitis characterized by necrotizing granulomatous inflammation affecting predominantly small-and medium-sized blood vessels. While GPA can affect any organ system, it most frequently presents with respiratory tract involvement, encompassing the upper and lower airways, as well as renal disease[1]  \naDepartment of Pulmonary Medicine, National University Hospital, Damascus, Syrian Arab Republic, bChildren’s Hospital, Damascus, Syrian Arab Republic, cStemosis for Scientific Research, Damascus, Syrian Arab Republic, dFaculty of Medicine, International University of Africa, Khartoum, Sudan, eUniversity of Bahri, Faculty of Medicine, Khartoum, Sudan and fUniversity of Aleppo, Faculty of Medicine, Aleppo, Syrian Arab Republic  \nHanaen Hamed is the first author.  \nSponsorships or competing interests that may be relevant to content are disclosed at the end of this article.  \n*Corresponding author. Address: Faculty of Medicine, University of Aleppo, Villat Street, Aleppo, Syrian Arab Republic. Tel.: +963 943434363.  \n[E-mail: gmichael.kabbabe@gmail.com](E-mail: gmichael.kabbabe@gmail.com) (G.M. Kabbabe).  \nCopyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons AttributionNon Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Annals of Medicine & Surgery (2026) 88:891–895  \nReceived 17 January 2025; Accepted 19 November 2025  \nPublished online 1 December 2025  \n[http://dx.doi.org/10.1097/MS9.0000000000004494](http:","cbCaiaiCKYNDYQ37","https://ap.wps.com/l/cbCaiaiCKYNDYQ37","pdf",921827,"English","# Introduction\n# Case Presentation\n# Clinical Discussion\n# Conclusion\n# Highlights\n# Diagnosis and Disease Overview","[{\"question\":\"What symptoms did the 58-year-old patient present with, and how was the initial diagnosis handled?\",\"answer\":\"He presented with hemoptysis, cough, fever, joint pain, and fatigue. He was initially diagnosed with pneumonia, then later identified as having GPA when symptoms persisted or recurred with supportive serology.\"},{\"question\":\"What diagnostic marker supported GPA in this case?\",\"answer\":\"Positive cytoplasmic antineutrophil cytoplasmic antibodies (c-ANCA) supported granulomatosis with polyangiitis alongside clinical findings.\"},{\"question\":\"How was treatment managed, and what was the outcome?\",\"answer\":\"High-dose corticosteroids were initiated due to hypoxia and alveolar hemorrhage, followed by rituximab. The patient improved significantly, was discharged, and continued close follow-up.\"}]","Lung-limited granulomatosis with polyangiitis and the importance of early treatment - a case report | PDF",1790674783,13]