Abstract
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is a rare multisystem autoimmune disease resulting from necrotizing inflammation of small vessels. Genetic predisposition and environmental factors are typically associated with its presentation, though rarely a drug-induced form has been reported. Here, we present a case of a 73-year-old female with a history of hypertension and chronic kidney disease who presented with acute kidney injury secondary to hydralazine-induced ANCA vasculitis. This report aims to highlight the rare association of hydralazine with vasculitis and the importance of pursuing a full initial workup in patients with acute kidney injury.