Antineutrophil cytoplasmic antibody-associated vasculitis complicated by subarachnoid hemorrhage: A case report and literature review
Abstract
Rationale: antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is an autoimmune syndrome characterized by necrotizing inflammation of small-to medium-sized vessels accompanied by the presence of peripheral blood ANCA. Subarachnoid hemorrhage (SAH) is an uncommon complication of AAV. The purpose of this report is to present a rare case of AAV complicated by SAH and to review the existing literature, thereby enhancing awareness of this severe neurological manifestation and its management strategies.
Patient concerns: We report the case of a 56-year-old male who presented with cough, blood-tinged sputum, proteinuria, elevated serum creatinine levels, and headache. Laboratory examinations confirmed the presence of anti-myeloperoxidaseantibody, imaging revealed SAH, and angiography identified a ruptured anterior communicating artery aneurysm.
Diagnoses: The final diagnosis was AAV complicated by SAH.
Interventions: The patient underwent prompt endovascular coiling, with concurrent immunosuppression using methylprednisolone and intravenous cyclophosphamide.
Outcomes: Following endovascular coiling, the patient's subarachnoid hemorrhage and associated neurological symptoms (headache, dizziness) resolved completely. Immunosuppressive therapy led to the resolution of respiratory symptoms (cough and blood-tinged sputum), the clearance of hematuria, and a significant reduction in inflammatory markers, such as C-reactive protein (CRP) and erythrocyte sedimentation…
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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