Question:
A patient presents with respiratory symptoms, that is, cough, hemoptysis, and glomerulonephritis. His c-ANCA levels in serum are found to be raised. The most likely diagnosis is
A patient presents with respiratory symptoms, that is, cough, hemoptysis, and glomerulonephritis. His c-ANCA levels in serum are found to be raised. The most likely diagnosis is
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c-ANCA (anti-PR3) with lung and kidney disease points to Wegener's granulomatosis, unlike Goodpasture's which is anti-GBM antibody driven.
Updated On: Jul 8, 2026
- Goodpasture's Syndrome
- Classic Polyarteritis Nodosa
- Wegener's Granulomatosis
- Kawasaki syndrome
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The Correct Option is C
Solution and Explanation
Step 1: Understanding the Question.
The patient has a lung and kidney combination, cough with coughing up blood plus glomerulonephritis, and the key laboratory clue is a raised c-ANCA. We must pick the disease this antibody pattern points to.
Step 2: Key Concept.
c-ANCA is directed against proteinase 3 (PR3) inside neutrophils and is strongly linked with Wegener's granulomatosis, now also called granulomatosis with polyangiitis (GPA). This disease is a small vessel vasculitis that classically involves the upper airway, lungs and kidneys together, giving a triad of sinus or nasal disease, pulmonary nodules or hemorrhage, and rapidly progressive glomerulonephritis.
Step 3: Detailed Explanation.
Goodpasture's syndrome also causes lung hemorrhage plus glomerulonephritis, but it is driven by anti glomerular basement membrane antibodies, not ANCA, so a raised c-ANCA argues against it.
Classic polyarteritis nodosa is a medium vessel vasculitis that spares the lungs and does not cause glomerulonephritis (it affects renal arteries, causing infarcts and hypertension rather than glomerular inflammation), and it is typically ANCA negative.
Kawasaki syndrome is a vasculitis of childhood that mainly affects the coronary arteries and presents with fever, rash, conjunctivitis and mucosal changes, not this lung-kidney, ANCA positive picture.
Only Wegener's granulomatosis fits both the clinical lung plus kidney picture and the c-ANCA positivity described.
Step 4: Final Answer.
The most likely diagnosis is Wegener's granulomatosis (granulomatosis with polyangiitis), option (3).
The patient has a lung and kidney combination, cough with coughing up blood plus glomerulonephritis, and the key laboratory clue is a raised c-ANCA. We must pick the disease this antibody pattern points to.
Step 2: Key Concept.
c-ANCA is directed against proteinase 3 (PR3) inside neutrophils and is strongly linked with Wegener's granulomatosis, now also called granulomatosis with polyangiitis (GPA). This disease is a small vessel vasculitis that classically involves the upper airway, lungs and kidneys together, giving a triad of sinus or nasal disease, pulmonary nodules or hemorrhage, and rapidly progressive glomerulonephritis.
Step 3: Detailed Explanation.
Goodpasture's syndrome also causes lung hemorrhage plus glomerulonephritis, but it is driven by anti glomerular basement membrane antibodies, not ANCA, so a raised c-ANCA argues against it.
Classic polyarteritis nodosa is a medium vessel vasculitis that spares the lungs and does not cause glomerulonephritis (it affects renal arteries, causing infarcts and hypertension rather than glomerular inflammation), and it is typically ANCA negative.
Kawasaki syndrome is a vasculitis of childhood that mainly affects the coronary arteries and presents with fever, rash, conjunctivitis and mucosal changes, not this lung-kidney, ANCA positive picture.
Only Wegener's granulomatosis fits both the clinical lung plus kidney picture and the c-ANCA positivity described.
Step 4: Final Answer.
The most likely diagnosis is Wegener's granulomatosis (granulomatosis with polyangiitis), option (3).
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