A 48-year-old man presented to the rheumatology outpatient department with arthralgia and tinnitus, with a tentative diagnosis of otitis media. He reported difficulty walking for at least a month and was unable to walk for the last 2 days. Neurologic examination suggested a severe neuropathy. He was urgently admitted to the hospital with a preliminary diagnosis of vasculitis. A few hours later, he developed massive pulmonary hemorrhage and was intubated. A urinary catheter was placed, revealing macroscopic hematuria, which was followed by an anuric rapidly progressive acute kidney injury.