Arch Intern Med Res 2019; 2 (2): 077-084 DOI: 10.26502/aimr.0015 Archives of Internal Medicine Research 77 Case Report ANCA Negative Vasculitis Presenting with Interstitial Lung Disease and Pancytopenia Kriti Gupta * , Behtash Saeidi, William Pascal Department of Internal medicine, Maimonides Medical Centre, New York, United States * Corresponding author: Kriti Gupta, Department of Internal medicine, Resident physician, Maimonides Medical Centre, Brooklyn, New York, United States, Tel: 718-283-6000; E-mail: kriti0934@gmail.com Received: 20 October 2019; Accepted: 06 December 2019; Published: 17 December 2019 Citation: Kriti Gupta, Behtash Saeidi, William Pascal. ANCA Negative Vasculitis Presenting with Interstitial Lung Disease and Pancytopenia. Archives of Internal Medicine Research 2 (2019): 077-084. Abstract Introduction: MPA (or microscopic polyarteritis) is clinically described as patients with exclusively nongranulomatous small vessel vasculitis involving the upper or lower respiratory tract (e.g., alveolar capillaritis). The most common manifestation of MPA is necrotizing glomerulonephritis and/or pulmonary capillaritis. Serologically, more than 90% of MPA patients have a positive antineutrophil cytoplasmic antibodies (ANCA). There have been selective case reports documenting pancytopenia associated with vasculitis. Case: Here, we discuss a 56 year old female patient who presented with pancytopenia, and was found to have biopsy-proven small vessel vasculitis with negative ANCA. She presented with 5-6 weeks of worsening generalized fatigue, cough with hemoptysis, intermittent fever, and shortness of breath on exertion and weight loss of 8lbs over this time. On presentation, she was febrile (102F) and found to have pancytopenia, with normal kidney function. She was admitted to the Intensive Care Unit for a presumed viral illness and underwent a bone marrow biopsy for evaluation of pancytopenia. Further imaging with computerized tomography (CT) scan demonstrated ground glass haziness. Bone marrow biopsy revealed normal results. She was discharged with the diagnosis of a pancytopenic viral illness. She returned 4 weeks later with worsening of her symptoms. CT chest showed significant interval changes compared to previous CT with bilateral ground glass opacities. Lung biopsy was performed which showed small vessel vasculitis. Repeat CT chest following steroid treatment demonstrated significant improvement.