TY - JOUR T1 - Lesson of the month: Severe granulomatosis with polyangiitis (GPA): a diagnostic challenge during the COVID-19 pandemic JF - Clinical Medicine JO - Clin Med SP - 79 LP - 80 DO - 10.7861/clinmed.2020-0793 VL - 21 IS - 1 AU - Qurratulain Qurratulain AU - Azeem Ahmed AU - Quentin Jones Y1 - 2021/01/01 UR - http://www.rcpjournals.org/content/21/1/79.abstract N2 - 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. ER -