A 46-year-old woman presents with chronic sinusitis, recurrent otitis media, and hemoptysis. She reports progressive dyspnea and denies tobacco use. Vital signs: BP 148/92, HR 102, RR 22, SpO2 91% on room air. Laboratory studies show serum creatinine 2.8 mg/dL (baseline 0.9) and positive c-ANCA with anti-PR3 antibodies. CT chest demonstrates multiple cavitary nodules with surrounding infiltrates. Urinalysis shows hematuria without proteinuria. Which diagnosis best explains these findings?
- A)Goodpasture syndrome
- B)Sarcoidosis
- C)Granulomatosis with polyangiitisGABARITO
- D)Eosinophilic granulomatosis with polyangiitis
- E)Microscopic polyangiitis
Explicação
Granulomatosis with polyangiitis is correct. The combination of upper airway disease, lower respiratory tract cavitary nodules, glomerulonephritis, and c ANCA positivity is classic. Necrotizing granulomatous vasculitis affects small to medium vessels and can c... Ver explicação completa e trilha adaptativa →