Acute Respiratory Distress Syndrome in A 32-Year-Old Man with Newly Diagnosed Wegener’s Granulomatosis C-ANCA Positive Pauci Immune Crescentic Glomerulonephritis with Leucopenia Treated Successfully: A Rare Case Report
Authors:   Professor and Head/ Senior Consultant Physician, Department of Medicine/ Department of Nephrology, Defence Services Medical Academy/ No. (1) Defence Services General Hospital (1000 Bedded), Myanmar, Pyar Khin Phyu , Hlaing Soe Win ,   Senior Consultant Physician, No. (1) Defence Services General Hospital (1000 Bedded), Myei Chann ,   Consultant Intensivist, No. (1) Defence Services General Hospital (1000 Bedded), Sein Thidar ,   Consultant Radiologist, No. (1) Military Hospital (700 Bedded), Pyin Oo Lwin, Hlaing Ohmar ,   Professor and Head/ Senior Consultant Radiologist, Department of Radiology, Defence Services Medical Academy, Htet Aung ,   Consultant Radiologist, No. (1) Defence Services General Hospital (1000 Bedded), Kyaw Aung Htoo ,   Consultant Physician, No. (1) Defence Services General Hospital (1000 Bedded), Myo Aung ,   Consultant Chest Physician, No. (1) Defence Services General Hospital (1000 Bedded), Aung Aung ,   Consultant Hematologist, No. (1) Defence Services General Hospital (1000 Bedded), Tun Zaw Min ,   Consultant Chest Physician, No. (1) Defence Services General Hospital (1000 Bedded), Aung Zar Ni Htet ,   Senior Consultant Physician, No. (1) Defence Services General Hospital (1000 Bedded), Aung Soe Min ,   Senior Consultant Physician, No. (1) Defence Services General Hospital (1000 Bedded), Maung Nyan Lin ,   Senior Consultant Physician, No. (1) Defence Services General Hospital (1000 Bedded), Myint Thein Tun ,   Senior Consultant Physician, No. (1) Defence Services General Hospital (1000 Bedded), Maung Kyaw Thet ,   Senior Consultant Physician, No. (1) Defence Services General Hospital (1000 Bedded), Thu Aung ,   Senior Consultant Physician, No. (1) Defence Services General Hospital (1000 Bedded), Aung Han Lin ,   Senior Consultant Physician, No. (1) Defence Services General Hospital (1000 Bedded), Win Thurein ,   Senior Consultant Physician, No. (1) Defence Services General Hospital (1000 Bedded), Kyaw Aung Phyoe ,   Senior Consultant Physician, No. (1) Defence Services General Hospital (1000 Bedded), Lynn Aung Nyan ,   Senior Consultant Physician, No. (1) Defence Services General Hospital (1000 Bedded), Htet Naing Shin ,   Consultant Chest Physician, No. (1) Defence Services General Hospital (1000 Bedded), Wah Saw Thar ,   Senior Consultant Physician, No. (1) Defence Services General Hospital (1000 Bedded), Oo Soe Ko Ko ,   Senior Consultant Physician, No. (1) Defence Services General Hospital (1000 Bedded), Kyaw Myo Thant ,   Senior Consultant Physician, No. (1) Defence Services General Hospital (1000 Bedded), Latt Aung Phyo ,   Senior Consultant Physician, No. (1) Defence Services General Hospital (1000 Bedded), Aung Zay Phyo ,   Senior Consultant Physician, No. (1) Defence Services General Hospital (1000 Bedded), Htun Soe Moe ,   Consultant Chest Physician, No. (1) Defence Services General Hospital (1000 Bedded), Lin Than Naing ,   Consultant Chest Physician, No. (1) Defence Services General Hospital (1000 Bedded), Min Sit ,   Senior Consultant Physician, No. (1) Defence Services General Hospital (1000 Bedded), Htun Win Min ,   Senior Consultant Physician, No. (1) Defence Services General Hospital (1000 Bedded), Kyaw Sein ,   Radiologist, No. (1) Defence Services General Hospital (1000 Bedded), Ko Myat Ko ,   Consultant Pathologist, Department of Pathology, Defence Services Medical Academy, Htwe Zaw Min ,   Radiologist, No. (1) Defence Services General Hospital (1000 Bedded)
Published: January 2025

A 32-year-old man presented with myalgia, polyarthritis, hearing problem, sneezing, erythematous rash, episcleritis for one month. As serum creatinine was high, renal biopsy was done; it was compatible with pauci immune glomerulonephritis. Blood c-ANCA was positive; and, both anti-glomerular basement membrane antibody and p-ANCA were negative. Therefore, he was diagnosed as a case of Wegener’s Granulomatosis with rapidly progressive glomerulonephritis, and treated with corticosteroids, cyclophosphamide and rituximab. Hemodialysis was initiated shortly after immunosuppressive treatment as serum creatinine was rising. He developed dyspnea and low SaO2 due to acute respiratory distress syndrome (ARDS). Total WBC count was low (2.1X109 /L). He was successfully treated with continuous positive airway pressure (CPAP).