@article {Qurratulain79, author = {Qurratulain Qurratulain and Azeem Ahmed and Quentin Jones}, title = {Lesson of the month: Severe granulomatosis with polyangiitis (GPA): a diagnostic challenge during the COVID-19 pandemic}, volume = {21}, number = {1}, pages = {79--80}, year = {2021}, doi = {10.7861/clinmed.2020-0793}, publisher = {Royal College of Physicians}, abstract = {We present the case of a 71-year-old woman with bilateral pneumonia who continued to deteriorate despite multiple courses of antibiotics. When dexamethasone was added to cover the possibility of COVID-19 pneumonia, she rapidly improved. Subsequently, she was found to have a strongly positive PR3 anti-nuclear cytoplasmic antibody (ANCA) and clinical features consistent with granulomatosis with polyangiitis (GPA) with upper respiratory tract and renal involvement. The case highlights how the COVID-19 pandemic can create new challenges in the diagnosis of GPA.}, issn = {1470-2118}, URL = {https://www.rcpjournals.org/content/21/1/79}, eprint = {https://www.rcpjournals.org/content/21/1/79.full.pdf}, journal = {Clinical Medicine} }