College
Rowan-Virtua School of Osteopathic Medicine
Hydralazine-Induced Vasculitis Resulting in Large Pleural Effusion and Progressive Renal Dysfunction
Keywords
Anti-Neutrophil Cytoplasmic Antibody-associated vasculitis, drug-induced acute kidney injury, hydralazine-induced vasculitis, drug-related side effects, vasculitis
Date of Presentation
5-1-2025 12:00 AM
Poster Abstract
Hydralazine is a vasodilator commonly used to treat high blood pressure. Even with the safety profile of Hydralazine, it is necessary to know that it may lead to Hydralazine-Induced Vasculitis. Here, we discuss how this rare side effect can present in an 80-year-old female with a past medical history of hypertension who presented to the emergency department with complaints of progressive shortness of breath on exertion and while lying supine. Further evaluation revealed a large right-sided pleural effusion with consolidation at the right lower lobe. The patient’s dyspnea worsened, and the surgical team placed a chest tube. The patient also experienced deteriorating kidney function and was noted to have proteinuria. Further workup revealed elevated Proteinase 3 (PR3), Myeloperoxidase (MPO), and anti-histone antibodies. A renal biopsy showed moderate interstitial fibrosis and 22% globally sclerosed glomeruli, leading to the diagnosis of Hydralazine-induced ANCA vasculitis.
Disciplines
Cardiovascular Diseases | Emergency Medicine | Heterocyclic Compounds | Medicine and Health Sciences | Nephrology | Pathological Conditions, Signs and Symptoms | Pulmonology
Included in
Cardiovascular Diseases Commons, Emergency Medicine Commons, Heterocyclic Compounds Commons, Nephrology Commons, Pathological Conditions, Signs and Symptoms Commons, Pulmonology Commons
Hydralazine-Induced Vasculitis Resulting in Large Pleural Effusion and Progressive Renal Dysfunction
Hydralazine is a vasodilator commonly used to treat high blood pressure. Even with the safety profile of Hydralazine, it is necessary to know that it may lead to Hydralazine-Induced Vasculitis. Here, we discuss how this rare side effect can present in an 80-year-old female with a past medical history of hypertension who presented to the emergency department with complaints of progressive shortness of breath on exertion and while lying supine. Further evaluation revealed a large right-sided pleural effusion with consolidation at the right lower lobe. The patient’s dyspnea worsened, and the surgical team placed a chest tube. The patient also experienced deteriorating kidney function and was noted to have proteinuria. Further workup revealed elevated Proteinase 3 (PR3), Myeloperoxidase (MPO), and anti-histone antibodies. A renal biopsy showed moderate interstitial fibrosis and 22% globally sclerosed glomeruli, leading to the diagnosis of Hydralazine-induced ANCA vasculitis.
