Microscopic polyangiitis (MPA) is an autoimmune condition belonging to a group of vasculitides driven by interactions between anti-neutrophil cytoplasmic antibodies (ANCAs) and proteins within neutrophilic granules.1 Hydralazine, a direct-acting vasodilator, is a drug commonly used to treat hypertension, but is also known to induce a lupus like reaction, as well as AAV. Although life-threatening, there remains mysteries regarding hydralazine-induced microscopic polyangiitis, and investigation into these mysteries could prove lifesaving for patients. A total of 62 articles and books published from 1983 to 2026 were chosen through literature searches in PubMed, Science Direct, Embase, Elsevier, and Google scholar. Search terms were “hydralazine-induced microscopic polyangiitis” or “microscopic polyangiitis” as Mesh terms, and subsequent terms included “drug-induced vasculitides,” “glomerulonephritis,” and “diffuse alveolar hemorrhage.” Inclusion criteria included global studies focused on microscopic polyangiitis or drug induced vasculitides within the last fifty years, exclusion criteria studies older than fifty years. The most reliable diagnostic methods were proven to be a combination of ELISA and IIF for antibodies and histopathological evaluation after a detailed history from the patient. A consensus among the literature points to a combination therapy including corticosteroids and other immunosuppressants or biologics. However, detriments in the literature include demographic studies, mortality rates, and pathophysiology of the condition. Further research is needed to investigate epidemiology, exact pathophysiology, and mortality rates to develop treatment guidelines or prevent the disease altogether.

Diurnal enuresis can significantly affect a child’s biopsychosocial well-being; however, there is a lack of diagnostic and management algorithms on the diagnosis. The purpose of this literature review is to dissect the development of the evaluation and management of diurnal enuresis. A total of 44 articles published from January 1900 to December 2024 were chosen through literature searches in PubMed, Science Direct, Embase, and Google scholar. Search terms were “Diurnal Enuresis” or “Daytime Incontinence” as Mesh terms, and subsequent terms included “pediatrics”, “urinary bladder, overactive”, and “therapeutics”. Inclusion criteria included studies involving pediatric study subjects aged 5–18 years old with a specific diagnosis of diurnal enuresis, exclusion criteria were studies before 1900 and involving night-time wetting diagnoses. A consensus among the literature and the American Academy of Family Physicians recommends a stepwise diagnostic evaluation, including history taking followed by a focused physical exam, for diurnal enuresis has proven to be the most effective. Regarding treatment, biofeedback was shown to improve symptoms in 74% of cases in one study by Wiener, while pharmacological treatment via Mirabegron (beta 3 agonist) showed a 70% improvement in one study by Fryer, but older drugs such as oxybutynin (anticholinergics) are still preferred. A multidisciplinary approach with TENS therapy, behavioral modification, biofeedback, and pharmacology can enhance effectiveness, improve reliability, and provide more successful results while minimizing the impact of diurnal enuresis on a child’s well-being. Further research is needed to optimize pharmacologic management strategies and improve adherence to increase the likelihood of reaching treatment goals.

Diurnal enuresis, or daytime wetting, can significantly affect a child’s biopsychosocial well-being, however, there is a lack of diagnostic and management algorithms on the diagnosis. The purpose of this literature review is to analyze the efficacy of the evaluation and management of diurnal enuresis. A total of 44 articles published from January 1900 to December 2024 were chosen through literature searches in PubMed, Science Direct, Embase, and Google scholar were used. Search terms were “Diurnal Enuresis” or “Daytime Incontinence” as Mesh terms and subsequent terms included “pediatrics”, “urinary bladder, overactive”, and “therapeutics” to name a few. Inclusion criteria included studies involving pediatric study subjects starting at 5 years old with a specific diagnosis of diurnal enuresis, exclusion criteria were any studies before 1900 and studies involving night-time wetting diagnoses.A consensus among the literature and the American Academy of Family Physicians recommends that a stepwise diagnostic evaluation, including history taking followed by a focused and pertinent physical exam, for diurnal enuresis has proven to be the most effective. Regarding treatment, biofeedback was shown to improve symptoms in 74% of cases in one study by Wiener, while pharmacological treatment via Mirabegron (beta 3 agonist) showed 70% improvement in one study by Fryer, but older drugs such as oxybutynin (anticholinergics) are still preferred. However, most literature postulates that a multidisciplinary approach with TENS therapy, behavioral modification, biofeedback, and pharmacology can enhance effectiveness, improve reliability, and provide more successful results while minimizing the impact of diurnal enuresis on a child's overall well-being.