Abdullah Ahmed, Anwar Muhammad Saad, Ijaz Maria, Karim Muhammad Sikandar, Rosen Raquel, Bokhari Syed Rizwan A
Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Neurology, AINeuroCare, Dallas, USA.
Cureus. 2022 Dec 16;14(12):e32603. doi: 10.7759/cureus.32603. eCollection 2022 Dec.
Hydralazine is a vasodilator used in the treatment of resistant hypertension. It is a safe and widely used antihypertensive medicine. Its common adverse effects include headache, rebound tachycardia, fluid retention, and angina. It is a rare cause of anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) with pulmonary and renal involvement. We report a case of a 74-year-old woman, with over eight years of use of hydralazine, who presented to the hospital with shortness of breath and cough. Blood work revealed deranged renal function with high creatinine levels. Serology workup was positive for anti-histone antibodies (AHA), anti-nuclear antibodies (ANA), myeloperoxidase (MPO) ANCA and proteinase-3 (PR-3) ANCA. Renal biopsy showed diffusely flattened tubular epithelium, focal micro vesicular degeneration, and focal loss of the brush border of the proximal tubular epithelium. Hydralazine was stopped and the patient was treated with corticosteroids, resulting in the resolution of her kidney injury.
肼屈嗪是一种用于治疗顽固性高血压的血管扩张剂。它是一种安全且广泛使用的抗高血压药物。其常见不良反应包括头痛、反弹性心动过速、液体潴留和心绞痛。它是抗中性粒细胞胞浆抗体（ANCA）相关血管炎（AAV）伴肺和肾受累的罕见病因。我们报告一例74岁女性病例，该患者使用肼屈嗪超过八年，因呼吸急促和咳嗽入院。血液检查显示肾功能紊乱，肌酐水平升高。血清学检查抗组蛋白抗体（AHA）、抗核抗体（ANA）、髓过氧化物酶（MPO）-ANCA和蛋白酶-3（PR-3）-ANCA呈阳性。肾活检显示肾小管上皮弥漫性扁平、局灶性微泡变性以及近端肾小管上皮刷状缘局灶性缺失。停用肼屈嗪后，患者接受皮质类固醇治疗，肾损伤得以缓解。
