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CT scan of the chest showed multiple lung nodules with cavitation. We gave intravenous cyclophosphamide and corticosteroids as induction therapy for granulomatosis with polyangiitis. Unfortunately, during the induction phase, he developed diffuse alveolar haemorrhage and progressive mononeuritis multiplex. We subsequently gave intravenous rituximab and C5a receptor antagonist, avacopan. 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