ANCA-negative microscopic polyangiitis with diffuse alveolar hemorrhage masquerading as congestive heart failure

Autoimmunity Highlights

Table 1 Autoimmune and infectious workup results during first admission

Lab	Results	Lab	Results	Lab	Results
WBC	9.3	Neutrophils	75.9%	Potassium	2.9
Hgb	13.1	Lymphocytes	12.5%	Sodium	138
Hct	37.8	Eosinophils	1.3%	Creatinine	2.03
Platelet	343	Monocytes	10.1%	GFR	52
Troponin	0.232	D-Dimer	1.3	TSH	1.65
CRP	80	GBM Ab	Negative	CMV IgM	Negative
ESR	67	SS-A/Ro	Negative	Cox A & B Ab	Negative
ANA	1:160 (Homogenous)	SS-B/La	Negative	Cryptococcal Ag	Negative
RF	< 10	ACA (IgG, IgM)	< 9	EBV DNA	Negative
Anti-CCP	4	TTG (IgA, IgG)	1, 3	HBV DNA	Negative
ANCA	Negative	Ribosome IgG	3	HCV RNA	Negative
Anti ds-DNA	Negative	Endomysial IgG	< 1:10	HIV 1&2 Ab	Negative
Anti-Smith Ab	Negative	Anti Gliadin	< 7	Parvovirus B19	Negative
Histone auto Ab	Negative	Anti Gliadin	< 2	Syphilis (RPR/FTA)	Negative
Scl-70 Ab	Negative	Free Kappa	1.73	HHV6 DNA	Negative
C3	130	Free Lambda	1.49	Lyme ELISA	Negative
C4	32.4	K/L Ratio	1.16	Histoplasma Ag	Negative
IgA	250	IgG	1160	IgM	1110

WBC White Blood Cell, Hgb Hemoglobin, Hct Hematocrit, GFR Glomerular Filtration Rate, TSH Thyroid Stimulating Hormone, Ab Antibody, Ig Immunoglobulin, ESR Erythrocyte Sedimentation Rate, CRP C-Reactive Protein, ANA Anti-Neutrophil Antibody, ANCA Anti-Neutrophil Cytoplasmic Antibody, Scl Scleroderma, C3 Complement 3, C4 Complement 4, ds-DNA Double-Stranded DNA, RF Rheumatoid Factor, CCP Cyclic Citrullinated Peptide, SS-A Sjӧgren-Syndrome-related-antigen A, SS-B Sjӧgren-syndrome-related-antigen B, ACA Anti Cardiolipin Ab, TTG Tissue trans-glutaminase, HIV Human Immunodeficiency Virus, HCV Hepatitis C Virus, HBV Hepatitis B Virus, CMV Cytomegalovirus, EBV Epstein-Barr Virus, Cox A & B Coxsackievirus A & B, HHV Human Herpes Virus, RPR: Rapid Plasma Reagin, FTA Fluorescent Treponemal Antibody

ISSN: 2038-3274