Case of the Month #25 - ANCA vasculitis

Published 01/02/2022


A 61 year old lady presents to hospital with lethargy, generalised aches and pains, cough and 2 episodes of loose stool. She has a past medical history of type 2 diabetes, hypertension and obesity.

Drug history is as follows: Metformin 1g BD, Empaglaflozin 10mg OD, Ramipril 5mg OD, Simvastatin 40mg OD, Furosemide 20mg OD, Paracetamol 1g PRN.

Urine dipstick shows 3+ Blood, 2+ Protein, negative Leucocytes, negative Nitrites. Bloods show Creatinine 403 umol/L (baseline Creatinine 102 umol/L 4 months ago), Urea 19 mmol/L, K+ 6.1 mmol/L, Na 132 mmol/L, bicarbonate 17 mmol/L and the patient has passed only 45 ml of urine in the past 6 hours. The patient is requiring 35% oxygen to maintain oxygen saturations of 95%.  Chest X-ray shows evidence of areas of diffuse alveolar shadowing.

ICU are contacted for assistance.


Written by Dr Rick Bell

First published 13 Jan 2022