COVID-19 and granulomatosis with polyangiitis (GPA): a diagnostic challenge

Shenavandeh, Saeedeh; Sefidbakht, Sepideh; Iranpour, Pooya; Teimouri, Arash; Hooshmandi, Sedighe; Hooshmandi, Etrat; Athari, Mohammadjavad

doi:10.1093/rheumatology/keaa326

Cited by 6 publications

(3 citation statements)

References 6 publications

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“…Clinicians are blindsighted by COVID-19, often missing conditions such as GPA. 4 Despite being in a pandemic, clinicians must have a broad differential diagnosis, especially when the clinical picture is not consistent with COVID-19. Our patient had normal oxygen saturation and downtrending inflammatory markers, yet her renal function continued to deteriorate with persistent haematuria and proteinuria.…”

Section: Discussionmentioning

confidence: 99%

COVID-19-induced granulomatosis with polyangiitis

et al. 2021

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COVID-19 and granulomatosis with polyangiitis share many clinical and radiological features, making it challenging for clinicians to distinguish between the two. In this case report, we describe a patient who was diagnosed with COVID-19 in October 2020. One month later, she presented with persistent fatigue, shortness of breath and anaemia with worsening renal functions, found to have elevated antineutrophil cytoplasmic antibodies and antiproteinase 3 antibodies, and diagnosed with granulomatosis with polyangiitis.

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Section: Discussionmentioning

confidence: 99%

COVID-19-induced granulomatosis with polyangiitis

et al. 2021

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“…However, initial diagnosis was challenging for two reasons: firstly, there were diagnostic algorithms implemented in response to the global pandemic to ensure appropriate levels of patient safety; secondly, the prodromal overlap and patient characteristics between ANCA-positive vasculitis and COVID-19 further complicated the diagnosis. 4,5 ANCA-positive vasculitides are the most common small-vessel vasculitides and include microscopic polyangiitis, eosinophilic granulomatosis with polyangiitis (Churg-Strauss Syndrome), and granulomatosis with polyangiitis (Wegener's granulomatosis). They are frequently missed or delayed in their diagnosis due to their nonspecific symptoms.…”

Section: Discussionmentioning

confidence: 99%

Massive Alveolar Haemorrhage Presenting During the COVID-19 Pandemic

et al. 2021

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The coronavirus disease (COVID-19) pandemic has challenged healthcare systems and has resulted in complex diagnostic processes for patients with non-COVID-19 pathology. Here, we demonstrate a case of massive alveolar haemorrhage secondary to antineutrophil cytoplasmic antibody-positive vasculitis, presented to a district general hospital in the UK during the first wave of the global pandemic. This case highlights some of the difficulties clinicians may face when diagnosing life-threatening antineutrophil cytoplasmic antibody-positive vasculitis amidst the COVID-19 pandemic. The authors place emphasis on the careful interpretation of chemical biomarkers such as troponin and D-dimer when assessing patients with acute respiratory distress. They also aim to highlight the importance of CT thorax imaging when seeking an alternate diagnosis to COVID-19.

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“…The emergence of the novel coronavirus disease (COVID-19) in Wuhan, China, towards the conclusion of 2019 has prompted inquiries into its pathogenesis, therapy, and clinical presentations across various health conditions (1). Previous research indicated that elderly individuals exhibited a heightened vulnerability to experiencing severe infection and consequences arising from COVID-19 (2). The reverse transcription polymerase chain reaction (RT-PCR) test is extensively employed as a diagnostic modality for COVID-19; nevertheless, it is associated with a notable incidence of false negative results.…”

Section: Introductionmentioning

confidence: 99%

Do chest CT findings predict the outcome in pregnant patients with COVID-19 pneumonia? A cross-sectional study

Esmaeilian,

Teimouri,

Hoseinyazdi

et al. 2024

Preprint

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Background: COVID-19 is a novel infectious disease that poses significant challenges for the management of pregnant patients, especially regarding the use and interpretation of chest CT scans. This study aimed to evaluate the clinical significance and radiological features of chest CT scans in pregnant women with COVID-19. Methods: The authors conducted a cross-sectional, multi-center study of 53 pregnant women with confirmed COVID-19 by RT-PCR testing who underwent chest CT scans in three hospitals in Iran. They collected and analyzed data on demographic, clinical, laboratory, and radiological variables, as well as maternal and neonatal outcomes. They used low-dose chest CT protocol and abdominal shields to minimize radiation exposure and assessed the interobserver reliability of the chest CT diagnosis using Cohen’s kappa coefficient. Results: The study included 41 pregnant women with COVID-19 and available chest CT scans. The mean maternal age was 34.6±7.60 years and the mean gestational age was 28.73±5.66 weeks. Dyspnea was the most common symptom (85.4%), followed by fever (68.3%) and cough (51.2%). Asthma (p=0.001) and diabetes (p=0.001) were significantly associated with worse outcomes and abnormal chest CT scans. Myalgia (p=0.001), respiratory distress (p=0.001), admission O2 saturation (p=0.001), leukopenia (p=0.001), lymphocytosis (p=0.001), and high CRP levels (p=0.001) were also correlated with adverse outcomes and abnormal chest CT scans. Normal chest scans were observed in 25 patients (61%), while 16 patients (39%) had abnormal CT scan findings. Ground glass opacity (81.3%) and consolidation (68.8%) were the most common radiological features on chest CT scans. Four maternal deaths occurred due to delayed referral and underlying comorbidities such as heart failure or renal failure. Conclusion: The percentage of lung involvement and the presence of consolidation on chest CT scans could predict the prognosis of pregnant women with COVID-19. Chest CT scans could be a useful tool for the diagnosis and management of COVID-19 in pregnancy, especially in cases of severe symptoms or comorbidities.

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COVID-19 and granulomatosis with polyangiitis (GPA): a diagnostic challenge

Abstract: COVID-19 and granulomatosis with polyangiitis (GPA): a diagnostic challenge Rheumatology key message. Accurate diagnosis of COVID infection is especially important in those with comorbid lung conditions such as GPA.

Cited by 6 publications

References 6 publications

COVID-19-induced granulomatosis with polyangiitis

COVID-19-induced granulomatosis with polyangiitis

Massive Alveolar Haemorrhage Presenting During the COVID-19 Pandemic

Do chest CT findings predict the outcome in pregnant patients with COVID-19 pneumonia? A cross-sectional study

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