Anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis is a rare autoimmune condition characterized by inflammation of small- and medium-sized vessels. ANCA-associated vasculitis can lead to multisystem organ complications, including life-threatening pulmonary hemorrhage, renal failure and death. We present a case of ANCA-associated vasculitis complicated by complement-mediated thrombotic microangiopathy (c-TMA). Of the rheumatic diseases, systemic lupus erythematosus…