{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T20:35:44Z","timestamp":1777581344459,"version":"3.51.4"},"reference-count":13,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,6,8]]},"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:p>A man in his 40s with end-stage kidney disease due to IgA nephropathy and receiving peritoneal dialysis presented with a 1-week history of breathlessness, cough and nosebleeds. CT scan of the chest revealed ground glass changes while blood tests indicated elevated inflammatory markers and a negative vasculitis screen. This included negative ANCA and anti-GBM antibodies. Initial treatment for suspected atypical pneumonia with antibiotics yielded no clinical improvement.<\/jats:p>\n               <jats:p>Over the course of the admission, his symptoms progressively worsened, leading to oxygen dependency with a FiO2 of 40% and episodes of haemoptysis. Suspicions of pulmonary vasculitis arose due to clinical deterioration, prompting consultation with a tertiary vasculitis centre. It was subsequently concluded that the clinical and radiological findings correlated with ANCA-negative pulmonary vasculitis or a rare case of IgA-associated pulmonary capillaritis. Treatment with methylprednisolone and rituximab led to significant improvement, allowing rapid oxygen withdrawal. The patient was discharged with a tapering prednisolone regimen.<\/jats:p>","DOI":"10.1136\/bcr-2023-258766","type":"journal-article","created":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T03:55:31Z","timestamp":1718855731000},"page":"e258766","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["ANCA negative pulmonary vasculitis: a challenging diagnosis"],"prefix":"10.1136","volume":"17","author":[{"given":"Yimeng","family":"Zhang","sequence":"first","affiliation":[{"name":"Renal Medicine, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK"},{"name":"University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kara","family":"Mayor","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amar","family":"Mahdi","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,6,19]]},"reference":[{"key":"2025082710004402000_17.6.e258766.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2012.03.015"},{"key":"2025082710004402000_17.6.e258766.2","unstructured":"Danoff SK . 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