Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 8 6 2024 09 29 270 274 EN Matineh Sadat Tabatabaei School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran Mostafa Mortazi Faculty of Medicine, Alborz University of Medical Sciences, Alborz, Iran 2023 12 03 2024 05 05 Granulomatosis with polyangiitis, previously known as Wegener’s, is a necrotizing vascular disease that affects small blood vessels and may cause damage to the respiratory tract and kidneys. In this article, we report on a 50-year-old male with a complicated disease process who experienced rare bladder and renal complications and several adverse drug reactions. Despite using drug alternatives, the side effects remained mostly the same. Therefore, by studying different cases and articles, we establish the relation between these findings and the specifications of granulomatosis with polyangiitis. This case underscores the complexity of managing this condition and the need for personalized treatment strategies. https://crcp.tums.ac.ir/index.php/crcp/article/view/901 https://crcp.tums.ac.ir/index.php/crcp/article/download/901/595