{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T21:53:44Z","timestamp":1777672424266,"version":"3.51.4"},"reference-count":11,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Investigative Medicine High Impact Case Reports"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:p>The differential diagnosis of a patient presenting with constitutional symptoms and pulmonary cavitary lesions on chest X-ray is broad, including pulmonary tuberculosis (TB) and vasculitic lung disease. Clinicians may consider sociodemographic factors in sequencing their differential, which should be verified with diagnostic tests according to appropriate pretest probability. Here, we present a case of misdiagnosing granulomatosis with polyangiitis as pulmonary TB. Although native to an endemic country, this patient had multiple negative TB tests and did not respond to rifampin, isoniazid, pyrazinamide, and ethambutol therapy. We consider anchoring implicit bias as a contributing factor for this patient\u2019s misdiagnosis and make recommendations for clinicians.<\/jats:p>","DOI":"10.1177\/23247096251344722","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T05:46:27Z","timestamp":1774935987000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Overcoming Anchoring Bias: Granulomatosis With Polyangiitis in a Patient From a Tuberculosis-Endemic Region"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4898-5393","authenticated-orcid":false,"given":"Arianna","family":"Rahimian","sequence":"first","affiliation":[{"name":"Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leenah","family":"Abojaib","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donias","family":"Doko","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Kashkouli","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Garlapati P Rout P Qurie A. Granulomatosis with polyangiitis. In: StatPearls; 2024. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK557827\/"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2010.04.002"},{"issue":"1","key":"e_1_3_3_4_2","first-page":"20","article-title":"Wegener\u2019s granulomatosis versus pulmonary tuberculosis: a dilemma","volume":"12","author":"Mason A","year":"2024","unstructured":"Mason A, Jethani V, Kumar R, Singh YP. Wegener\u2019s granulomatosis versus pulmonary tuberculosis: a dilemma. Chest. 2024;12(1):20.","journal-title":"Chest"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.41.3.219"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.13-4-411"},{"issue":"4","key":"e_1_3_3_7_2","first-page":"88","article-title":"A challenging differential diagnosis: granulomatosis with polyangiitis and tuberculosis","volume":"15","author":"Restrepo MJ","year":"2020","unstructured":"Restrepo MJ, Miranda JV, Vel\u00e1squez MA, Franco CAV. A challenging differential diagnosis: granulomatosis with polyangiitis and tuberculosis. Int J Clin Rheum. 2020;15(4):88.","journal-title":"Int J Clin Rheum"},{"key":"e_1_3_3_8_2","unstructured":"ASM.org. Why pretest and posttest probability matter in the time of COVID-19. https:\/\/asm.org:443\/Articles\/2020\/June\/Why-Pretest-and-Posttest-Probability-Matter-in-the Accessed 2025."},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2023.2366"},{"key":"e_1_3_3_10_2","article-title":"Hidden diagnosis behind viral infection: the danger of anchoring bias","volume":"2018","author":"Iwai K","year":"2018","unstructured":"Iwai K, Tetsuhara K, Ogawa E, et al. Hidden diagnosis behind viral infection: the danger of anchoring bias. Case Rep. 2018;2018:bcr2018226613.","journal-title":"Case Rep"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.7861\/fhj.2020-0233"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12911-016-0377-1"}],"container-title":["Journal of Investigative Medicine High Impact Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23247096251344722","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23247096251344722","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23247096251344722","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:04:52Z","timestamp":1777449892000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23247096251344722"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":11,"alternative-id":["10.1177\/23247096251344722"],"URL":"https:\/\/doi.org\/10.1177\/23247096251344722","relation":{},"ISSN":["2324-7096","2324-7096"],"issn-type":[{"value":"2324-7096","type":"print"},{"value":"2324-7096","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]},"article-number":"23247096251344722"}}