A 45-year-old male presents to his physician complaining of achy joints,chronic runny nose,and coughing up blood.Chest x-ray shows pulmonary nodules.Cortisol is increased; ESR is slightly elevated.Tests for autoantibodies are positive for cytoplasmic antineutrophil cytoplasmic antibodies.This patient has:

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The symptoms described are indicative of Wegener's granulomatosis, which is an autoimmune disease that causes inflammation of blood vessels in the nose, throat, and lungs. The presence of pulmonary nodules, high cortisol, and positive cytoplasmic antineutrophil cytoplasmic antibodies are all consistent with this diagnosis. Systemic lupus erythematosus and rheumatoid arthritis typically do not cause pulmonary nodules or coughing up blood. Chronic granulomatous disease is a genetic disorder that affects the immune system, but it does not present with the specific symptoms described.

A 45-Year-Old Male Presents to His Physician Complaining of Achy