Microscopic polyangiitis is a necrotizing vasculitis characterized by systemic involvement of capillaries, venules, and arterioles. The average age of patients at the time of microscopic polyangiitis verification is 42 (51-65) years. Almost all patients with microscopic polyangiitis have antineutrophil cytoplasmic antibodies. Antibodies to myeloperoxidase are more common than antibodies to proteinase-3. The disease is most commonly characterized by involvement of small vessels in the kidneys and lungs, as well as a high frequency of end-stage chronic kidney disease and mortality. Patients with microscopic polyangiitis have a low risk of exacerbation and a low frequency of arterial hypertension despite renal involvement. The article discusses the clinical spectrum of organ involvement in microscopic polyangiitis and presents a case description of a 39-year-old woman with renal, lung, and heart involvement against the background of concomitant bronchiectatic disease. High titers of myeloperoxidase antibodies were detected in the enzyme immunoassay. Patient R., 39 years old, was diagnosed with microscopic polyangiitis on August 31, 2021, and died on June 28, 2024, with a disease duration of 35 months (147 weeks, 3 years).