{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:26:50Z","timestamp":1760956010305,"version":"3.44.0"},"reference-count":14,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,4,29]]},"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:p>We report a patient with antineutrophilic cytoplasmic antibody (ANCA) vasculitis that was preceded by witnessed black widow spider bites. The patient initially presented with a diffuse painful skin rash that developed after a few hours post bite. He was treated initially with topical ointment for the suspected bite. However, subsequently a few days later the patient returned to the hospital with similar, but more progressive rash with haemoptysis and acute hypoxic respiratory failure requiring supplemental oxygen. Immunology work up showed elevated titre of peri-nuclear ANCA. Bronchoscopy revealed diffuse alveolar haemorrhage. The patient was treated successfully with methylprednisolone and rituximab.<\/jats:p>","DOI":"10.1136\/bcr-2019-233710","type":"journal-article","created":{"date-parts":[[2020,6,18]],"date-time":"2020-06-18T06:19:48Z","timestamp":1592461188000},"page":"e233710","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["P-ANCA vasculitis with diffuse alveolar haemorrhage preceded by a spider bite"],"prefix":"10.1136","volume":"13","author":[{"given":"Ali Hameed","family":"Ali","sequence":"first","affiliation":[{"name":"Internal Medicine, UCSF, Fresno, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mandip Singh","family":"Kang","sequence":"additional","affiliation":[{"name":"Internal Medicine, UCSF, Fresno, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaafar","family":"Aldahwi","sequence":"additional","affiliation":[{"name":"VA Medical Center Fresno, Fresno, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Candice","family":"Reyes","sequence":"additional","affiliation":[{"name":"Internal Medicine, UCSF Fresno Center for Medical Education and Research Edward and Ann Hildebrand Medical Library, Fresno, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,6,17]]},"reference":[{"key":"2025082623202877000_13.6.e233710.1","unstructured":"Microscopic polyangiitis. 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