{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:44:09Z","timestamp":1782603849283,"version":"3.54.5"},"reference-count":27,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,10,13]]},"abstract":"<jats:p>Hydralazine, a vasodilator, is commonly used as an adjunctive treatment for moderate to severe hypertension, heart failure and hypertensive emergencies in pregnancy. Hydralazine-induced lupus was first described in 1953. Clinical presentation ranges from arthralgia, myalgia, petechiae, or rash to single or multiorgan involvement. An occurrence of systemic vasculitis is a rare complication. When presented as the pulmonary\u2013renal syndrome, it could have a rapidly progressive course which can be fatal. Here, we describe a case of hydralazine-associated rapidly progressive glomerulonephritis and pulmonary haemorrhage. We use this case to review the current literature and discuss and highlight the importance of a high degree of clinical acumen, early diagnosis and prompt treatment for better clinical outcomes.<\/jats:p>","DOI":"10.1136\/bcr-2018-227161","type":"journal-article","created":{"date-parts":[[2018,11,9]],"date-time":"2018-11-09T02:25:48Z","timestamp":1541730348000},"page":"bcr-2018-227161","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":32,"title":["Hydralazine-associated antineutrophil cytoplasmic antibody vasculitis with pulmonary\u2013renal syndrome"],"prefix":"10.1136","volume":"2018","author":[{"given":"Narothama Reddy","family":"Aeddula","sequence":"first","affiliation":[{"name":"Nephrology, Deaconess Health System, Evansville, Indiana, USA"},{"name":"Medicine, Indiana University School of Medicine, Evansville, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samata","family":"Pathireddy","sequence":"additional","affiliation":[{"name":"Internal Medicine, Deaconess Health System, Evansville, Indiana, USA"},{"name":"Medicine, Indiana University School of Medicine, Evansville, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asif","family":"Ansari","sequence":"additional","affiliation":[{"name":"Nephrology, Permian Basin Kidney Center, Midland, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J","family":"Juran","sequence":"additional","affiliation":[{"name":"Nephrology, Deaconess Health System, Evansville, Indiana, USA"},{"name":"Medicine, Indiana University School of Medicine, Evansville, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,11,8]]},"reference":[{"key":"2025082700164218000_2018.nov08_1.bcr-2018-227161.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2015.05.160"},{"key":"2025082700164218000_2018.nov08_1.bcr-2018-227161.2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01910215"},{"key":"2025082700164218000_2018.nov08_1.bcr-2018-227161.3","doi-asserted-by":"crossref","first-page":"42-9","DOI":"10.1097\/BOR.0000000000000014","article-title":"Trojan horses: drug culprits associated with antineutrophil cytoplasmic autoantibody (ANCA) vasculitis","volume":"26","author":"Pendergraft","year":"2014","journal-title":"Curr Opin Rheumatol"},{"key":"2025082700164218000_2018.nov08_1.bcr-2018-227161.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2010.04.002"},{"key":"2025082700164218000_2018.nov08_1.bcr-2018-227161.5","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1111\/j.1365-2249.1990.tb05342.x","article-title":"Autoantibodies against neutrophil cytoplasm components in systemic lupus erythematosus and in hydralazine-induced lupus","volume":"81","author":"N\u00e4ssberger","year":"1990","journal-title":"Clin Exp Immunol"},{"key":"2025082700164218000_2018.nov08_1.bcr-2018-227161.6","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(93)91761-A"},{"key":"2025082700164218000_2018.nov08_1.bcr-2018-227161.7","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200002)43:2<405::AID-ANR22>3.0.CO;2-5"},{"key":"2025082700164218000_2018.nov08_1.bcr-2018-227161.8","doi-asserted-by":"publisher","DOI":"10.3109\/s10165-009-0168-y"},{"key":"2025082700164218000_2018.nov08_1.bcr-2018-227161.9","first-page":"1","article-title":"Hydralazine-associated vasculitis: Overlapping features of drug-induced lupus and vasculitis","volume":"5","author":"Kumar","year":"2018","journal-title":"Semin Arthritis Rheum"},{"key":"2025082700164218000_2018.nov08_1.bcr-2018-227161.10","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfm493"},{"key":"2025082700164218000_2018.nov08_1.bcr-2018-227161.11","doi-asserted-by":"publisher","DOI":"10.1177\/096120339400300608"},{"key":"2025082700164218000_2018.nov08_1.bcr-2018-227161.12","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.2169\/internalmedicine.51.6775","article-title":"An elderly patient with diabetic nephropathy complicated by ANCA-associated nephritis","volume":"51","author":"Nishino","year":"2012","journal-title":"Intern Med"},{"key":"2025082700164218000_2018.nov08_1.bcr-2018-227161.13","doi-asserted-by":"crossref","first-page":"1638-45","DOI":"10.1007\/s001250050628","article-title":"How often is NIDDM complicated with non-diabetic renal disease? 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