Case Report

Sensory-Motor Polyneuropathy and Digital Ischemia: A Rare Presentation of Granulomatosis with Polyangiitis

Table 1

Summary of investigations.

InvestigationValueReference range

White cell count93004,000–11,000 cells/μL
Neutrophils66002,000–7,000 cells/μL
Lymphocytes11201,000–4,000 cells/μL
Hemoglobin12.012–16 g/dL
Platelets177,000150,000–450,000/μL
Blood filmNo abnormal cells seen. Within normal limits
Serum creatinine6570–110 μmol/L
Sodium136135–145 mmol/L
Potassium4.23.5–4.5 mmol/L
AST20<40 U/L
ALT25<35 U/L
Albumin3535–45 g/L
Globulin3830–40 g/L
ALP10630–120 U/L
ESR110<20 mm/1st hour
CRP36<6 mg/L
Rheumatoid factor<8<8 IU/L
Antinuclear antibodiesNegative
HIV 1 and 2 antigens/antibodiesNegative
c-ANCAPositive
p-ANCANegative
Anti-Smith antibodyNegative
Anti-Scl-70 antibodyNegative
Anti-Ro antibodyNegative
Anti-La antibodyNegative
Lupus anticoagulantNegative
Anticardiolipin antibody, IgMNegative
Anti-ß2 glycoprotein antibodies, IgM and IgGNegative
Serum complement levelNormal
Serum cryoglobulinNegative
Hepatitis C antibodyNegative
Hepatitis B surface antigenNegative
Urine full reportNormal
Chest X-rayNo abnormality detected
Ultrasound abdomenNormal
2D echocardiogramNo abnormality detected including any cardiac source of emboli
HbA1C6.0%

AST, aspartate transaminase; ALT, alanine transaminase; ALP, alkaline phosphatase; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; TSH, thyroid stimulating hormone; HIV, human immunodeficiency virus; c-ANCA, cytoplasmic antineutrophil cytoplasmic antibody; p-ANCA, perinuclear antineutrophil cytoplasmic antibody.