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We describe a 68-year-old man who developed rapidly progressive glomerulonephritis due to myeloperoxidase (MPO)-ANCA-associated microscopic polyangiitis within 6\u2009months of a diagnosis of seropositive rheumatoid arthritis. The diagnosis was established following an acute deterioration in renal function, positive MPO-ANCA serology and renal biopsy demonstrating pauci-immune necrotising crescentic glomerulonephritis. This case emphasises the importance of considering ANCA-associated vasculitis in patients with rheumatoid arthritis who develop acute kidney injury, even early in the disease course.<\/jats:p>","DOI":"10.1136\/bcr-2026-272069","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T05:25:21Z","timestamp":1788499521000},"page":"e272069","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Rapidly progressive glomerulonephritis in rheumatoid arthritis: an early presentation of ANCA-associated vasculitis"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8081-6734","authenticated-orcid":false,"given":"Jegadis","family":"Sreeneyasan","sequence":"first","affiliation":[{"name":"Salford Royal NHS Foundation Trust, Salford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Dewar","sequence":"additional","affiliation":[{"name":"Salford Royal NHS Foundation Trust, Salford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seema","family":"Rana","sequence":"additional","affiliation":[{"name":"Salford Royal NHS Foundation Trust, Salford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamil","family":"Choudhury","sequence":"additional","affiliation":[{"name":"Salford Royal NHS Foundation Trust, Salford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Alderson","sequence":"additional","affiliation":[{"name":"Salford Royal NHS Foundation Trust, Salford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarang","family":"Chitale","sequence":"additional","affiliation":[{"name":"Rheumatology, Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust, Wigan, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"2026090322251425000_19.9.e272069.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2010.04.003"},{"key":"2026090322251425000_19.9.e272069.2","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s10067-018-4212-1","article-title":"Prevalence of overlap of antineutrophil cytoplasmic antibody associated vasculitis with systemic autoimmune diseases: an unrecognized example of poliautoimmunity","volume":"38","author":"Mart\u00edn-Nares","year":"2019","journal-title":"Clin Rheumatol"},{"key":"2026090322251425000_19.9.e272069.3","doi-asserted-by":"crossref","DOI":"10.1186\/s40064-015-0835-8","article-title":"Association of ANCA associated vasculitis and rheumatoid arthritis: a lesser recognized overlap syndrome","volume":"4","author":"Draibe","year":"2015","journal-title":"Springerplus"},{"key":"2026090322251425000_19.9.e272069.4","doi-asserted-by":"crossref","DOI":"10.1155\/2015\/402826","article-title":"Pauci-Immune Crescentic Glomerulonephritis: An ANCA-Associated Vasculitis","volume":"2015","author":"Syed","year":"2015","journal-title":"Biomed Res Int"},{"key":"2026090322251425000_19.9.e272069.5","doi-asserted-by":"publisher","DOI":"10.1002\/art.27584"},{"key":"2026090322251425000_19.9.e272069.6","doi-asserted-by":"crossref","DOI":"10.1186\/s12882-022-02788-6","article-title":"Anti-neutrophil cytoplasmic antibody associated vasculitis in patients with rheumatoid arthritis","volume":"23","author":"Wu","year":"2022","journal-title":"BMC Nephrol"},{"key":"2026090322251425000_19.9.e272069.7","doi-asserted-by":"publisher","DOI":"10.1186\/ar3256"},{"key":"2026090322251425000_19.9.e272069.8","unstructured":"Vakiti A , Padala SA , Hashmi MF , et al . 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