A rare large-vessel involvement in a patient with a clinical diagnosis of granulomatosis with polyangiitis: A case report

A previously healthy 22-year-old female presented with complaints of fatigue, joint pain, headache, fever, and night sweats for several months. She also reported a reddish painful left eye and a rash on her legs 2 months ago. On examination, her blood pressure was elevated at 160/100 mmHg and her lower limb pulses were hardly palpable. On investigation, she had anterior and intermediate uveitis, nasal septal ulcer, proteinuria, positive cytoplasmic anti-neutrophil cytoplasmic antibodies (C-ANCA), and a computed tomography angiography showed multiple abdominal aortic aneurysms and occlusion of both the left common carotid artery and the right superficial femoral artery. Lymph node biopsy showed necrotising granulomatous inflammation. The patient was diagnosed with granulomatosis with polyangiitis (GPA) with large-vessel involvement, which is a rare finding.