Hydralazine-Induced ANCA Vasculitis Presenting With Pericarditis: A Novel Case and Literature Review

Hydralazine, a commonly used arterial vasodilator for managing congestive heart failure and hypertension, is known to be associated with drug-induced lupus and, less frequently, antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV). Drug-induced AAV typically carries a favorable lon...

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Main Authors: Ahmed Sami Hammami, Osejie Oriaifo, Sinda Hidri, Sukhvir Singh, Husam El Sharu, Joshua Peltz, Soroush Nomigolzar, Kunjan Udani
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Case Reports in Cardiology
Online Access:http://dx.doi.org/10.1155/cric/9932632
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Summary:Hydralazine, a commonly used arterial vasodilator for managing congestive heart failure and hypertension, is known to be associated with drug-induced lupus and, less frequently, antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV). Drug-induced AAV typically carries a favorable long-term prognosis and is not commonly linked to cardiovascular or ocular involvement. Pericarditis cases associated with hydralazine have not been previously reported. We present a rare case involving an 85-year-old woman on long-term hydralazine therapy, initially presenting with acute lobar pneumonia. During her hospitalization, she developed pericarditis, chemosis, and conjunctivitis in her eyes, along with cutaneous lesions described as a maculopapular rash on her face, tender bullae on her digits, and a petechial rash on her back. Laboratory findings were consistent with drug-induced AAV, showing positive myeloperoxidase and proteinase 3 antibodies. An attempted diagnostic pericardiocentesis was unsuccessful. Hydralazine was discontinued, and she was successfully treated with corticosteroids and tolerated immunosuppression well. Subsequently, she recovered and was discharged from the hospital.
ISSN:2090-6412