{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T14:21:14Z","timestamp":1764253274009,"version":"3.46.0"},"reference-count":7,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T00:00:00Z","timestamp":1742428800000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Granulomatosis with Polyangiitis (GPA) is a rare vasculitis that can complicate the diagnostic process, especially in patients with complex medical histories. This case report details a 39\u2010year\u2010old woman with situs inversus totalis, Kartagener syndrome, and hypothyroidism, who presented to the emergency department with intermittent petechiae, purpura in the lower limbs, and fever following a trip to a malaria\u2010endemic region. Initial investigations suggested an infectious etiology, but extensive testing for malaria and other infections returned negative results. A transition to autoimmune disease assessment was prompted by the positive results of rheumatologic tests. Pulse doses of Methylprednisolone Sodium Succinate and Rituximab were initiated, and the treatment was continued with Prednisolone, Azathioprine, and Calcium D tablets. The patient's signs and symptoms have improved after this treatment. This case underscores the necessity of considering a comprehensive differential diagnosis and advocating for a meticulous and systematic approach in complex clinical presentations.<\/jats:p>","DOI":"10.1002\/ccr3.70327","type":"journal-article","created":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T00:25:40Z","timestamp":1742516740000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnosis of Granulomatosis With Polyangiitis in a 39\u2010Year\u2010Old Woman With a Recent History of Traveling to Malaria\u2010Endemic Region: A Case Report"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4950-5806","authenticated-orcid":false,"given":"Hanie","family":"Forouzandeh","sequence":"first","affiliation":[{"name":"School of Medicine Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7584-9124","authenticated-orcid":false,"given":"Ahmadreza","family":"Rajabi","sequence":"additional","affiliation":[{"name":"School of Medicine Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9713-1549","authenticated-orcid":false,"given":"Abbas Ali Torfeh","family":"Esfahani","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Tropical Medicine, School of Medicine Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2542-9885","authenticated-orcid":false,"given":"Farzin","family":"Khorvash","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Tropical Medicine, School of Medicine Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4688-991X","authenticated-orcid":false,"given":"Mansoor","family":"Karimifar","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Alzahra Hospital, Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,20]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_14_2_1","DOI":"10.3949\/ccjm.79.s3.01"},{"doi-asserted-by":"publisher","key":"e_1_2_14_3_1","DOI":"10.1016\/j.jbspin.2020.06.005"},{"doi-asserted-by":"publisher","key":"e_1_2_14_4_1","DOI":"10.1136\/pgmj.2005.042648"},{"doi-asserted-by":"publisher","key":"e_1_2_14_5_1","DOI":"10.1093\/rheumatology\/kep026"},{"doi-asserted-by":"publisher","key":"e_1_2_14_6_1","DOI":"10.1136\/annrheumdis-2021-221795"},{"doi-asserted-by":"publisher","key":"e_1_2_14_7_1","DOI":"10.1002\/art.41773"},{"doi-asserted-by":"publisher","key":"e_1_2_14_8_1","DOI":"10.1177\/0394632015617063"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.70327","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T14:17:50Z","timestamp":1764253070000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.70327"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":7,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1002\/ccr3.70327"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.70327","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"type":"print","value":"2050-0904"},{"type":"electronic","value":"2050-0904"}],"subject":[],"published":{"date-parts":[[2025,3]]},"assertion":[{"value":"2024-06-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70327"}}