A rare case of pulmonary renal syndrome with tripleseropositive for myeloperoxidase-anti neutrophil cytoplasm antibody (MPO-ANCA), proteinase 3 (PR3)-ANCA and antiglomerular basement membrane (GBM) antibodies

Anti-glomerular basement membrane (anti-GBM) disease and antineutrophil cytoplasm antibody (ANCA)-associated vasculitis are the main causes of pulmonary-renal syndrome (PRS). The concurrence of both ANCA - myeloperoxidase (MPO) and proteinase 3 (PR3) - and anti-GBM antibodies has been described, although positivity for all three antibodies has rarely been reported. The natural history of triplepositive patients as well as the best therapeutic approach remains unknown.