Perinuclear antineutrophil cytoplasmic antibody-associated vasculitis in an elderly woman.

Antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis encompasses 3 conditions: eosinophilic granulomatosis with polyangiitis (EGPA; formerly named Churg-Strauss syndrome), granulomatosis with polyangiitis (GPA; formerly named Wegener granulomatosis), and microscopic polyangiitis.1 Diagnosing ANCA-associated small-vessel vasculitis is challenging for clinicians because of its infrequent presentation (incidence of 20 per 1 million) and variable clinical manifestations.1,2 Antineutrophil cytoplasmic antibody– associated small-vessel vasculitis generally presents as a multisystem disease.2 Here we describe a case of ANCAassociated small-vessel vasculitis that underlines why it is important for family physicians to be familiar with this condition and to have an appropriately high index of suspicion to prevent lifethreatening end-organ damage.3