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Area of Science:

  • Immunology
  • Nephrology
  • Rheumatology

Background:

  • Granulomatosis with polyangiitis (GPA) is a systemic vasculitis affecting multiple organs, notably the respiratory tract and kidneys.
  • Diagnosis typically involves clinical suspicion, elevated antineutrophil cytoplasmic antibodies (ANCA), and organ biopsy confirmation.
  • Viral infections are implicated as potential triggers for GPA development.

Purpose of the Study:

  • To report a rare case of GPA.
  • To investigate the association between cytomegalovirus (CMV) infection and GPA onset.
  • To highlight diagnostic considerations in immunocompromised patients.

Main Methods:

  • Case report detailing clinical presentation and diagnostic workup.
  • Review of patient's medical history for underlying immunocompromised status.
  • Serological and biopsy confirmation of GPA and CMV infection.

Main Results:

  • The patient presented with clinical features suggestive of GPA.
  • Elevated ANCA titers and positive biopsy confirmed GPA.
  • Concurrent cytomegalovirus infection was identified in a patient with an undiagnosed immunocompromised state.

Conclusions:

  • Cytomegalovirus infection can precipitate GPA in individuals with previously unrecognized immunocompromise.
  • This case underscores the importance of considering viral triggers in GPA pathogenesis.
  • Early identification of underlying immune deficiencies is crucial for managing GPA.