The way ANCA affects vessel walls is not clear; various factors such as infection, environmental factors, and genetic factors as well as certain drugs including hydralazine, propylthiouracil, minocycline, cocaine use, and alpha-1 antitrypsin deficiency (AAT) are assumed to be the possible risk factors [9-11]. The gene discussed is SERPINA1; the disease is hyperinsulinemic hypoglycemia, familial, 4.