19-year-old diagnosed with rare autoimmune disease after lung masses mimic cancer

A 19-year-old university student in Changhua, Taiwan, faced a terrifying ordeal after seeking medical attention for chest pain and coughing up blood. Doctors discovered three large masses, each measuring 6-7 centimeters, in her lungs, which bore a striking resemblance to lung cancer tumors. The discovery left the student and her family deeply alarmed, fearing a cancer diagnosis.

Following a referral to the Taichung Hospital of the Ministry of Health and Welfare, the student underwent biopsies and immunological tests. These examinations revealed that she did not have cancer but instead suffered from Granulomatosis with Polyangiitis (GPA), an extremely rare autoimmune disease. Her condition has since stabilized following treatment with medication.

Dr. Wang Shih-kai from the hospital's Rheumatology and Immunology Department explained that GPA is characterized by the immune system abnormally attacking the body's own blood vessels. This inflammation and damage can obstruct blood flow, primarily affecting the upper and lower respiratory tracts and kidneys, including sinuses, lungs, and renal glomeruli. It can also impact other organs like the eyes, heart, and joints.

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Granulomatosis with Polyangiitis has an incidence rate of only about 0.37 in a million people, making it an extremely rare disease.

Dr. Wang noted that the disease progresses rapidly. Lung involvement can cause chest tightness, pain, and coughing up blood, potentially leading to respiratory failure from severe pulmonary hemorrhage. Kidney involvement can result in renal failure. Notably, GPA is more commonly seen in middle-aged and elderly individuals, making this 19-year-old's diagnosis unusual and underscoring the need for clinical diagnosis not to be solely based on age. The similarity of the lung lesions to cancer highlights the importance of pathological and immunological examinations for accurate diagnosis.

While the exact cause of GPA remains unknown, it is not contagious. Whether it has a hereditary component requires further research. With an incidence rate of approximately 0.37 per million people in Taiwan, it is exceptionally rare. However, advancements in diagnostic technology and treatments like immunosuppressants and steroids allow for effective disease control and reduced risk of organ damage and mortality if diagnosed and treated early.

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The lung lesions are extremely similar to lung cancer, but pathological biopsy shows vasculitis formed by granulomatous tissue, not cancer cells.