The patient was transferred to the intensive care unit for ongoing management. He was initiated on broad spectrum antibiotic therapy with pulsed steroids due to the suspicion of vasculitis. Urgent vasculitis screen revealed positive C-ANCA and anti-PR3 confirming the diagnosis of Granulomatosis with Polyangiitis. He went on to receive plasma exchange and cyclophosphamide on specialist advice of rheumatology. Alveolar haemorrhage can be the presenting manifestation in approximately 10% of patients with Granulomatosis with Polyangiitis.
