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<p>We report a rare case of a 63-year-old man with ulcerative colitis (UC) who presented with hemoptysis and was diagnosed with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), evidenced by positivity for both cytoplasmic-ANCA (c-ANCA) and perinuclear-ANCA (p-ANCA). Imaging and bronchoscopy supported pulmonary involvement. Glucocorticoid therapy led to rapid resolution of respiratory symptoms; however, steroid tapering triggered a UC flare requiring biologic therapy and eventual total colectomy. At the 3-year follow-up, the patient remained free of pulmonary symptoms. This case underscores the importance of considering AAV in UC patients with hemoptysis to enable early diagnosis and appropriate management.</p>

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Hemoptysis as the initial presentation of ANCA-associated vasculitis in a patient with ulcerative colitis: a case report and literature review

  • 期刊论文

  • 发表日期：

    2025年12月16日

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  • Meng-Hua Fan,
  • Jun Wu,
  • Cong-Cong Min,
  • Pin Meng,
  • Chen Jiang,
  • Hao Chen,
  • Hua Liu,
  • Xue-Li Ding,
  • Ai-Ling Liu

摘要

We report a rare case of a 63-year-old man with ulcerative colitis (UC) who presented with hemoptysis and was diagnosed with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), evidenced by positivity for both cytoplasmic-ANCA (c-ANCA) and perinuclear-ANCA (p-ANCA). Imaging and bronchoscopy supported pulmonary involvement. Glucocorticoid therapy led to rapid resolution of respiratory symptoms; however, steroid tapering triggered a UC flare requiring biologic therapy and eventual total colectomy. At the 3-year follow-up, the patient remained free of pulmonary symptoms. This case underscores the importance of considering AAV in UC patients with hemoptysis to enable early diagnosis and appropriate management.