{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T09:09:04Z","timestamp":1788340144760,"version":"build-2803163510"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T00:00:00Z","timestamp":1689292800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>We present a case of drug\u2010induced vasculitis secondary to low\u2010dose hydralazine with overlapping features of antineutrophil cytoplasmic antibody\u2010associated vasculitis and drug\u2010induced lupus nephritis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>A 52\u2010year\u2010old Hispanic woman with a medical history of resistant hypertension treated with hydralazine 10\u2009mg twice daily for 1\u2009year presented with generalized weakness, dizziness, nausea, vomiting, and gross hematuria. There was fever, tachycardia, leukocytosis, lactic acidosis, hyperkalemia, renal failure, and anemia. Chest computed tomography and bronchoscopy revealed a left lower lobe infiltrate and diffuse alveolar hemorrhage. Serologic testing was positive for anti\u2010double\u2010stranded DNA, anti\u2010Smith, lupus anticoagulant, anti\u2010histone, anti\u2010cardiolipin IgM antibodies, and antineutrophil cytoplasmic antibodies (myeloperoxidase and proteinase 3). A kidney biopsy revealed crescentic glomerulonephritis with an overlapping finding of membranous nephropathy. Broad\u2010spectrum antibiotics, immunosuppressants, corticosteroids, and plasmapheresis were initiated. The patient survived but required continuous hemodialysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although a few cases of simultaneous antibody\u2010associated vasculitis and drug\u2010induced lupus nephritis secondary to hydralazine use have been reported, this case is singular. Similar findings were previously reported with doses of 50\u2013100\u2009mg two to three times daily over 1\u20135\u2009years. In our patient, a dose of only 10\u2009mg twice daily for a year caused a severe disease presentation. This brings to light the combination of different vasculitides that can coexist and the potentially life\u2010threatening adverse effects of low\u2010dose hydralazine that should be kept in mind.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.14809","type":"journal-article","created":{"date-parts":[[2023,7,15]],"date-time":"2023-07-15T04:45:05Z","timestamp":1689396305000},"page":"2272-2277","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Overlapping drug\u2010induced vasculitis, ANCA\u2010associated vasculitis, and lupus nephritis caused by low\u2010dose hydralazine"],"prefix":"10.1111","volume":"26","author":[{"given":"M.","family":"Bhatnagar","sequence":"first","affiliation":[{"name":"Sunrise Health GME Consortium Mountain View Hospital  Las Vegas Nevada USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Agaronov","sequence":"additional","affiliation":[{"name":"College of 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