A case of granulomatosis with polyangiitis presenting as necrotizing pneumonia: A rare case report

Systemic vascular diseases frequently involve the respiratory system leading to inflammation of varying-sized vessels in the lungs by various immunological mechanisms. Granulomatosis with polyangiitis (Wegner’s granulomatosis) is one of the rare vascular diseases involving medium and small vessels in various organs. In typical cases, the upper and lower respiratory tract and kidneys are involved producing granulomatous inflammation of small arteries leading to necrotizing vasculitis usually associated with antineutrophil cytoplasmic antibodies (ANCA). Abnormal chest X-rays are seen in almost 70% of the patients during the course of the disease which includes nodules, infiltrate, and necrosis with subsequent cavitation. In rare cases, it may mimic the radiological features of pneumonia thus making the diagnosis difficult. So, here we present a case of a 53-year-old male who presented with necrotizing pneumonia with parapneumonic effusion later found out to be a case of C ANCA positive granulomatosis with polyangiitis.