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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author Ahmed Sami Hammami
Osejie Oriaifo
Sinda Hidri
Sukhvir Singh
Husam El Sharu
Joshua Peltz
Soroush Nomigolzar
Kunjan Udani
author_facet Ahmed Sami Hammami
Osejie Oriaifo
Sinda Hidri
Sukhvir Singh
Husam El Sharu
Joshua Peltz
Soroush Nomigolzar
Kunjan Udani
author_sort Ahmed Sami Hammami
collection DOAJ
description 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.
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series Case Reports in Cardiology
spelling doaj-art-5fe314cab72343de8f28514d8ff8e93b2025-08-20T03:06:30ZengWileyCase Reports in Cardiology2090-64122025-01-01202510.1155/cric/9932632Hydralazine-Induced ANCA Vasculitis Presenting With Pericarditis: A Novel Case and Literature ReviewAhmed Sami Hammami0Osejie Oriaifo1Sinda Hidri2Sukhvir Singh3Husam El Sharu4Joshua Peltz5Soroush Nomigolzar6Kunjan Udani7Department of Internal MedicineDepartment of Internal MedicineDepartment of Internal MedicineDepartment of Internal MedicineDepartment of Internal MedicineDepartment of Internal MedicineDepartment of CardiologyDepartment of CardiologyHydralazine, 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.http://dx.doi.org/10.1155/cric/9932632
spellingShingle Ahmed Sami Hammami
Osejie Oriaifo
Sinda Hidri
Sukhvir Singh
Husam El Sharu
Joshua Peltz
Soroush Nomigolzar
Kunjan Udani
Hydralazine-Induced ANCA Vasculitis Presenting With Pericarditis: A Novel Case and Literature Review
Case Reports in Cardiology
title Hydralazine-Induced ANCA Vasculitis Presenting With Pericarditis: A Novel Case and Literature Review
title_full Hydralazine-Induced ANCA Vasculitis Presenting With Pericarditis: A Novel Case and Literature Review
title_fullStr Hydralazine-Induced ANCA Vasculitis Presenting With Pericarditis: A Novel Case and Literature Review
title_full_unstemmed Hydralazine-Induced ANCA Vasculitis Presenting With Pericarditis: A Novel Case and Literature Review
title_short Hydralazine-Induced ANCA Vasculitis Presenting With Pericarditis: A Novel Case and Literature Review
title_sort hydralazine induced anca vasculitis presenting with pericarditis a novel case and literature review
url http://dx.doi.org/10.1155/cric/9932632
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