FCEM2-1806

FCEM2-1806

A 45-year-old woman presents with a bout of hemoptysis. She feels generally unwell and has experienced recent weight loss. Additionally, she has developed a rash. Her medical history includes a diagnosis of asthma last year and allergic rhinitis. On examination, she has a normal body temperature, her blood pressure is 180/95, and she has a purpuric rash primarily on her legs. During chest examination, a few scattered wheezes are heard.

Recently, she had a blood test, and the results are as follows:
– Hemoglobin (Hb): 10.4 g/dl (normal range: 13-17 g/dl)
– White blood cell count (WCC): 23.5 x 109/l (normal range: 4-11 x 109/l)
– Neutrophils: 8.2 x 109/l (normal range: 2.5-7.5 x 109/l)
– Lymphocytes: 2.1 x 109/l (normal range: 1.3-3.5 x 109/l)
– Eosinophils: 15.7 x 109/l (normal range: 0.04-0.44 x 109/l)
– C-reactive protein (CRP): 107 mg/l (normal range: <5 mg/l)
– Sodium (Na): 142 mmol/l (normal range: 133-147 mmol/l)
– Potassium (K): 4.6 mmol/l (normal range: 3.5-5.0 mmol/l)
– Creatinine (Creat): 255 micromol/l (normal range: 60-120 micromol/l)
– Urea: 14.8 mmol/l (normal range: 2.5-7.5 mmol/l)

What is the SINGLE most likely diagnosis?