text: Yo, check it out, this is the story of an 82-year-old queen,
  She came to the hospital, her symptoms were mean.
  Low-grade fever, anemia, her health was on the line,
  Nephritic syndrome progressing at a rapid pace, that ain't fine.
  
  Lab results showed proteinuria, her kidneys taking a hit,
  Renal failure mild, but she wasn't ready to quit.
  Myeloperoxidase-specific anti-neutrophil cytoplasmic autoantibody,
  A mouthful of words, but it's what they found, you see.
  
  Skin biopsy showed infiltration, purpura was red,
  Neutrophils around blood vessels, something to dread.
  Fibrinoid changes in the vessel walls, it's getting intense,
  Microscopic polyangiitis, the diagnosis makes sense.
  
  Corticosteroids came to the rescue, they played their part,
  Methylprednisolone through the veins, a treatment to start.
  Renal failure improved, the queen was getting strong,
  Four years later, a new challenge came along.
  
  Low-dose corticosteroid therapy, maintaining her health,
  But then came acute hepatitis B, it was bad for her wealth.
  Entecavir stepped in, the hero of the day,
  Liver dysfunction and jaundice faded away.
  
  Now here's a lesson we all need to know,
  When you're on immunosuppressive therapy, it's a blow.
  Check for HBV markers, don't ignore the signs,
  Prevent reactivation, protect those precious spines.
  
  So let this tale be a reminder, my friend,
  In the world of medicine, there's no time to pretend.
  Take care of your patients, keep their health in sight,
  And together, we'll fight the battles, day and night.