Vasculitis — Clinical

A 58-year-old Indian man presents with a 3-week history of progressive headache, jaw claudication, and visual blurring in the left eye. On examination, his left temporal artery is tender and non-pulsatile. ESR is 92 mm/h, CRP is 8.5 mg/dL, and hemoglobin is 10.2 g/dL. Fundoscopy shows optic disc pallor. What is the most appropriate next step in management?

A 42-year-old Indian woman presents with a 2-month history of progressive dyspnea, hemoptysis, and constitutional symptoms. Chest X-ray shows bilateral pulmonary infiltrates with cavitation. ANCA serology is positive for c-ANCA (cytoplasmic anti-neutrophil cytoplasmic antibodies) with anti-PR3 specificity. Serum creatinine is 3.2 mg/dL, and urinalysis shows dysmorphic RBCs with RBC casts. What is the most likely diagnosis?

A 58-year-old man with a 6-month history of constitutional symptoms, palpable purpura on lower extremities, and glomerulonephritis is found to have elevated inflammatory markers and positive ANCA (c-ANCA with anti-PR3 antibodies). A diagnosis of granulomatosis with polyangiitis (GPA) is made. What is the drug of choice for induction therapy in this patient?

A 62-year-old woman presents with headache, jaw claudication, visual blurring, and elevated ESR (95 mm/h). Temporal artery biopsy confirms giant cell arteritis (GCA). What is the drug of choice for initial management?

A 42-year-old Indian woman presents with a 2-month history of fever, malaise, and progressive dyspnea. She has palpable purpura on her lower extremities and abdomen. Urinalysis shows hematuria and proteinuria. Serum creatinine is 1.8 mg/dL. Complement levels (C3, C4) are normal. ANCA testing is negative. Skin biopsy shows IgA-dominant immune complex deposition on immunofluorescence. What is the most likely diagnosis?