Could COVID-19 Trigger Presentation or Exacerbation of Vasculitides? (A 14-Year-Old Girl with Newly Diagnosed GPA After COVID-19 Infection)

Raeeskarami, Seyed Reza; Mousavi, Seyyed Hosein; Ashouri, Mohammad; Akbariasbagh, Parvin; Assari, Raheleh; Naderi, Sahar

doi:10.5812/ijp.110597

Cited by 8 publications

(6 citation statements)

References 33 publications

(40 reference statements)

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“…[41,43,44] It has been suggested, but not yet conclusively demonstrated, that COVID-19 may be a predisposing factor for intestinal perforation in patients with ANCA-positive GPA. [46,47] The clinical course observed in our patient, who developed coronary pneumonia followed by sudden intestinal perforation a couple of months after he was admitted with GPA, is consistent with a possible COVID-19-induced vulnerability to GPA-associated intestinal perforation. In this regard, it is notable that our patient chest CT was atypical of GPA patients in that it did not reveal any ground glass changes, solid changes, or cavities.…”

Section: Discussionsupporting

confidence: 77%

Ileal perforation involvement in Wegener granulomatosis comorbid with COVID-19 infection: A case report and review of the literature

Shao,

Liu,

Zheng

et al. 2024

Medicine

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Rationale: Granulomatosis with polyangiitis (GPA) is a systematic autoimmune disease. The typical clinical involvement of GPA entails the upper and lower respiratory tracts, and the kidneys. Gastrointestinal (GI) involvement is uncommon and unless detected and treated promptly, may lead to life-threatening complications such as perforation. We aim to review all available publications since the first description in 1982 dealing with GI perforation in patients with Wegener granulomatosis and draw attention to this serious situation. Patient concerns: We present a 54-year-old man diagnosed with GPA who presented initially with nasal symptoms and suffered ileal perforation following Corona Virus Disease 2019 infection. We also review previously reported patients with Wegener granulomatosis who had GI perforation to investigate the perforation site and period, pathology, diagnosis, and treatment methods. Diagnoses and Interventions: The case of a GPA-diagnosed patient who presented initially with nasal symptoms and suffered ileal perforation following Corona Virus Disease 2019 infection. We recommended a renal puncture biopsy, steroids, and immunosuppressants to improve the patient condition. The patient and his family refused these treatment recommendations. Outcomes: Our patient exhibited continued progressive vascular inflammatory changes and eventual irreversible systemic damage. These sequelae were attributed to the patient declining prednisolone and immunosuppressant therapy. Lessons: GI perforation is rare in GPA but severe complication. Consequently, we recommend that early diagnosis and treatment with steroid hormones and immunosuppressants for GPA patients with GI perforation.

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Section: Discussionsupporting

confidence: 77%

Ileal perforation involvement in Wegener granulomatosis comorbid with COVID-19 infection: A case report and review of the literature

Shao,

Liu,

Zheng

et al. 2024

Medicine

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“…The current study presents a case of AAV after a COVID‐19 infection with neuropathy and limb paresthesia that has been reported for the first time. Neurologic involvement in COVID‐induced AAV has occurred in only three patients with manifestations ranging from facial allodynia and transverse myelitis to intracranial hemorrhage (ICH) previously 3–5 . Several studies have established a connection between SARS‐CoV‐2 infection and various neurological manifestations, such as headaches or specific conditions like Guillain–Barré syndrome or encephalitis 55 .…”

Section: Discussionmentioning

confidence: 99%

“…Her brain MRI showed an intracranial hemorrhage (ICH). 4 Other organs of the body were also affected with two cases of each cardiac involvement (myocarditis and STelevation myocardial infarction (STEMI)), gastrointestinal involvement and hearing loss. In summary, AAV can involve any part of the body and in post-COVID patients with similar presentations, it should be considered a primary differential diagnosis.…”

Section: Literature Reviewmentioning

confidence: 99%

“…A few days later, she had tonic–clonic seizures and experienced hemiparesis 3 weeks later. Her brain MRI showed an intracranial hemorrhage (ICH) 4 …”

Section: Literature Reviewmentioning

confidence: 99%

“…Glomerulonephritis (GN) and diffuse alveolar hemorrhage (DAH) are common presentations in post-COVID AAV patients while neurologic symptoms are very rare and have been reported in only three patients until now. [3][4][5][6][7] This study discusses a case with neuropathy and positive ANCA after COVID-19 infection.…”

Section: Introductionmentioning

confidence: 99%

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New‐onset ANCA‐associated vasculitis presenting with neuropathy after COVID‐19 infection: A case report and literature review

Mohamadi,

Soroureddin,

Nayebirad

et al. 2024

Clinical Case Reports

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Key Clinical MessageCoronavirus Disease 2019 (COVID‐19) is a viral infection caused by SARS‐CoV‐2, which can trigger autoimmune diseases such as antineutrophilic cytoplasmic antibody (ANCA) associated vasculitis (AAV) that affect small and medium‐sized blood vessels in multiple organs. This study discusses a case with neuropathy and positive ANCA after COVID‐19 infection and reviews the literature on AAV following COVID‐19 infection. A 59‐year‐old man is presented that was referred to Shariati Hospital for evaluation of neurologic problems after a COVID‐19 infection. Initially, he had flu‐like symptoms. A few days later, he developed right distal upper and lower limb paresthesia. His electromyography (EMG) and nerve conduction velocity (NCV) results were consistent with polyneuropathy. Lumbar puncture (LP) was normal except for positive COVID‐19 polymerase chain reaction (PCR). The patient's paresthesia worsened. Laboratory data showed leukocytosis, anemia, thrombocytosis, high erythrocyte sedimentation rate (ESR), and C‐reactive protein (CRP). Perinuclear anti‐neutrophil cytoplasmic antibody (MPO‐ANCA) was positive. According to the results, vasculitis was the main differential diagnosis. The sural nerve biopsy was performed, and the result was consistent with small to medium‐sized vessel vasculitis. The patient was diagnosed with COVID‐induced AAV. He was prescribed methylprednisolone and cyclophosphamide and was discharged with prednisolone and cotrimoxazole. In this study, a unique case of AAV induced by COVID‐19 infection confirmed by nerve biopsy is presented. A review of the literature found 48 cases of new‐onset AAV in adults and pediatrics after COVID‐19 infection. Further research is needed to completely understand the relationship between COVID‐19.

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COVID-19 associated pediatric vasculitis: A systematic review and detailed analysis of the pathogenesis

Batu¹,

Şener²,

Özen³

2022

Seminars in Arthritis and Rheumatism

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Could COVID-19 Trigger Presentation or Exacerbation of Vasculitides? (A 14-Year-Old Girl with Newly Diagnosed GPA After COVID-19 Infection)

Cited by 8 publications

References 33 publications

Ileal perforation involvement in Wegener granulomatosis comorbid with COVID-19 infection: A case report and review of the literature

Ileal perforation involvement in Wegener granulomatosis comorbid with COVID-19 infection: A case report and review of the literature

New‐onset ANCA‐associated vasculitis presenting with neuropathy after COVID‐19 infection: A case report and literature review

COVID-19 associated pediatric vasculitis: A systematic review and detailed analysis of the pathogenesis

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