Case Presentation: A 79-year-old woman with a past medical history of uncontrolled hypertension, migraine, and chronic kidney disease stage 3 presented with one week of poor oral intake, nausea, vomiting, vague abdominal pain, and chronic nonproductive cough. Physical exam revealed poor skin turgor, and lungs with crackles bilaterally. Laboratory studies showed Creatinine of 5.31 mg/dl [...]

Case Presentation: Introduction: Hydralazine is an adjunctive antihypertensive medication that is associated with antineutrophil cytoplasmic antibody (ANCA) – associated vasculitis. Kidney involvement usually comprises a pauci-immune, necrotizing glomerulonephritis with crescents. We describe a rare case of hydralazine induced ANCA positive vasculitis with acute tubulointerstitial nephritis and without glomerular involvement. Case Report: A 74 year old [...]

Case Presentation: We present a 79-year-old female treated with hydralazine for essential hypertension who initially presented to her primary care office with non-specific complaints of malaise, chills and unintentional weight loss. Routine laboratory evaluation was performed indicating a substantial rise from the patient’s baseline creatinine of 0.86mg/dL to 2.15mg/dL. Follow-up labs indicated continued worsening of [...]

Case Presentation: An 82-year-old female with diastolic heart failure presented with one-month worsening dyspnea on exertion and a week of scant hemoptysis and fatigue. She denied tuberculosis risk factors, night sweats, fevers, or skin, joint, or urinary changes. She was fully vaccinated against COVID-19. Her medications included aspirin and hydralazine. Her past medical, surgical, and [...]

Case Presentation: A 74-year-old African-American woman presented to our Emergency Department with hemoptysis and severe respiratory distress. Two weeks prior to presentation, she was admitted with persistent cough and blood streaked sputum of 1-month duration and was treated with antibiotics for a presumptive diagnosis of pnemonia after a negative bronchoscopy and bronchoalveolar lavage (BAL). Her [...]

Case Presentation: An 86-year-old woman with a history of hypertension on oral medications and chronic systolic heart failure presented to the hospital with chest pain and dyspnea. She was noted to be acutely hypertensive, tachypneic and hypoxemic. Physical exam revealed diffuse crackles, jugular venous distention and lower extremity pitting edema. EKG was consistent with an [...]

Case Presentation: An 83-year-old male with past medical history of hypertension managed chronically with hydralazine presented to the hospital complaining of acute onset of dyspnea, fever, and cough. He was treated for community acquired pneumonia with incomplete resolution of his symptoms. One month later he returned with fatigue and hemoptysis. Work up was significant for [...]

Case Presentation: We present a rare case of hydralazine-induced diffuse alveolar hemorrhage (DAH) in a 74-year-old male with a history of hypertension. The patient was admitted with symptoms including hemoptysis, dyspnea, and dark urine. Initial findings included a biopsy-confirmed leukocytoclastic vasculitis, elevated MPO antibodies, and evidence of DAH on bronchoscopy. Despite the absence of glomerulonephritis, [...]

Case Presentation: An 87-year-old female with stage 4 chronic kidney disease, hypertension, and heart failure presented with concern for acute kidney injury based on outpatient laboratory studies. She had sought prior care for worsening fatigue, lightheadedness, productive cough, and decreased urine output. Lab results revealed a creatinine of 4.4 mg/dL (baseline 1.7 mg/dL) and potassium [...]

Case Presentation: A 61-year-old African American male with DMII and HTN, presented with intermittent muscle twitching, abdominal pain and fatigue of 2 weeks duration. Physical exam was notable for subtle myoclonic jerks and mild pitting edema of bilateral lower extremities. Lab work showed hemoglobin of 6.6 g/dl, potassium of 5.8 mEq/L and creatinine of 12.2 [...]