Impact of corticosteroids on improving lung compliance in a patient with pulmonary microscopic polyangiitis

Microscopic polyangiitis (MPA) is a small-vessel vasculitis characterised by systemic infiltration, with a primary focus on the renal and pulmonary systems. One of its more lethal pulmonary manifestations is diffuse alveolar haemorrhage (DAH), although the spectrum of lung pathology in MPA is vast and calls for immediate immunosuppressive therapy. Our case looks at an older woman initially presenting with MPA-induced rapid progressive glomerulonephritis. However, she gradually develops an array of vasculitis-related pulmonary insults that necessitate endotracheal intubation, and following a short course of immunosuppression, her lungs undergo a rapid physiological recovery. This case highlights that induction therapy with steroids enhances lung compliance and results in a more profound respiratory recovery in ventilated MPA patients who lack DAH-related pulmonary symptoms.