Biphasic flow-volume loop in granulomatosis with polyangiitis related unilateral bronchus obstruction

Spirometry flow-volume measurement is used routinely in the outpatient setting to rule out obstructive lung diseases. Biphasic flow-volume loop is a classic presentation of unilateral bronchial stenosis due to multiple etiologies and it should raise clinical suspicion. Granulomatosis with polyangiitis (GPA) is a systemic inflammatory condition with pulmonary manifestations that may be infiltrative (e.g., pneumonia), hemorrhagic, and may rarely cause bronchial stenosis. Herein, we present a case of GPA-related, bronchial obstruction that caused biphasic flow-volume loop along with a literature review.