Acute Respiratory Distress Syndrome in A 32-Year-Old Man with Newly Diagnosed Wegener's Granulomatosis C-ANCA Positive Pauci Immune Crescentic Glomerulonephritis with Leucopenia Treated Successfully: A Rare Case Report

A 32-year-old man presented with myalgia, polyarthritis, hearing problem, sneezing, erythematous rash, episcleritis for one month. As serum creatinine was high, renal biopsy was done; it was compatible with pauci immune glomerulonephritis. Blood c-ANCA was positive; and, both anti-glomerular basement membrane antibody and p-ANCA were negative. Therefore, he was diagnosed as a case of Wegener’s Granulomatosis with rapidly progressive glomerulonephritis, and treated with corticosteroids, cyclophosphamide and rituximab. Hemodialysis was initiated shortly after immunosuppressive treatment as serum creatinine was rising. He developed dyspnea and low SaO2 due to acute respiratory distress syndrome (ARDS). Total WBC count was low (2.1X109 /L). He was successfully treated with continuous positive airway pressure (CPAP).