A 31-year-old Hispanic female patient with a complex medical history, including proteinase 3 (PR3)-positive granulomatosis with polyangiitis (GPA), rheumatoid arthritis, Raynaud phenomenon, seizure disorder, autism spectrum disorder, bipolar disorder with psychotic features, and cochlear implantation in childhood, was found to have genetically confirmed Alport syndrome through Natera testing (Natera, Inc., Austin, Texas, United States). Here, PRTN3 is linked to bipolar disorder.