COVID-19 and New Onset IgA Vasculitis: A Systematic Review of Case Reports

Messova, Assylzhan; Pivina, Lyudmila; Muzdubayeva, Zhanna; Sanbayev, Didar; Urazalina, Zhanar; Adams, Amber

doi:10.1016/j.jen.2022.05.002

Cited by 14 publications

(13 citation statements)

References 52 publications

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“…To our knowledge, 14 cases have been reported so far, excluding ours, and 6 of them were observed in children (16)(17)(18). In our series, median age was 45y as that was reported in the adults' cases from the literature.…”

Section: Discussionsupporting

confidence: 50%

Immunoglobulin A Vasculitis Following COVID-19: A French Multicenter Case Series

Ramdani

Galempoix²,

Augusto³

et al. 2022

J Rheumatol

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Objective IgA vasculitis (IgAV) usually occurs following viral respiratory tract infection. The SARS-CoV-2 infection has spread over the world. In this context, we describe a case series of patients who developed IgAV following SARS-CoV-2 infection. Methods This national multicentre retrospective study included patients with IgAV following SARS-CoV-2 infection, from the 1 January 2020 and 1 January 2022. Patients had histologically proven IgAV and RT-PCR proven SARS-CoV-2 infection. The interval time between infection and vasculitis onset had to be less than 4 weeks. Results We included 5 patients, 4 of them women with a mean age of 45 years. Four patients had paucisymptomatic infections and one required a 48-hours low-flow oxygen treatment. Five had purpuric skin involvement. Arthritis was observed in 2 patients, 3 had IgA glomerulonephritis and 2 had digestive involvements. Three renal biopsies were performed and showed mesangial IgA deposits without any extra-capillary proliferation. Median C-reactive protein was 180 mg/l [15.1-225], median serum creatinine level was 65 μmol/l [41-169], one patient had a glomerular filtration rate < 60 ml/min. Four patients received a first-line treatment, all with glucocorticoids. All patients had a favourable progression and 2 patients experienced minor skin relapses, one closely after COVID vaccination. Conclusion This series describes the emergence of IgAV closely following COVID-19 without us being able to eliminate an incidental link. Their outcome seems favourable. In most of our patients, the SARS-CoV-2 infection was pauci-symptomatic, encouraging an RT-PCR test to look for COVID-19 infection in patient without any evident trigger for IgAV.

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Section: Discussionsupporting

confidence: 50%

Immunoglobulin A Vasculitis Following COVID-19: A French Multicenter Case Series

Ramdani

Galempoix²,

Augusto³

et al. 2022

J Rheumatol

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“…Interestingly, antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis has also been reported in subjects with previously controlled HSP after COVID-19 infection [ 22 ]. A review showed that COVID-19-associated HSP affects mostly adults, and the concomitant presence of other diseases led to a more severe course of vasculitis in older patients developing acute renal failure [ 23 ]. From 2021, additional cases of typical HSP occurring with palpable purpura accompanied by abdominal pain, arthralgia, or periarticular swelling were observed in children or adolescents in whom the reverse transcriptase–polymerase chain reaction (RT-PCR) of nasopharyngeal swabs proved positive for SARS-CoV-2 [ 24 , 25 , 26 , 27 ].…”

Section: Environment Microbial and Virus Infectionsmentioning

confidence: 99%

Viral Infections May Be Associated with Henoch–Schönlein Purpura

Nikolaishvili

Pazhava

Lernia

2023

JCM

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Henoch–Schönlein purpura or IgA vasculitis is the most common type of pediatric vasculitis that may affect adults as well. It is classified as a type of small-vessel vasculitis. It can cause cutaneous and systemic symptoms with a minority of patients developing kidney failure. Little is known about the specific pathophysiology of this disorder, except that it is believed to occur in individuals with abnormally glycosylated IgA1. Serum aberrant IgA1 may form large antigen–antibody complexes which, due to a defective clearance, are able to deposit in the small vessels of the skin, kidney, gut, and joints. A variety of factors, including infectious agents, drugs, and vaccines, have been identified as potential triggers. The majority of cases are preceded by upper respiratory tract infections, and seasonal variations suggest a link with many pathogens. The etiologic agent most frequently associated with IgA vasculitis historically have been group A β-hemolytic streptococcus and common respiratory tract viruses. However, during the current coronavirus pandemic, SARS-CoV-2 infection was identified as a main trigger factor. In addition, IgA vasculitis has been observed following COVID-19 immunization. This review provides insights into the state of the art on the relationship between viral infections, viral vaccines, and Henoch–Schönlein purpura.

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“…While the pathogenesis of IgAV is not fully understood, symptoms are presumed to be secondary to IgA immune-complex deposition within the skin and viscera [9,10]. Recent reports have also associated the onset of IgAV with COVID-19 and group A streptococcus infections [11,12]. Laboratory studies in IgAV patients may show mild leukocytosis, elevated inflammatory markers (ESR and CRP), occasional eosinophilia, and normal platelet levels; however, definitive diagnosis is obtained via skin biopsy.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of an Annular Rash in an Adult with Multiple Risk Factors: A Case Report

Schnittka¹,

Lanpher²,

Haggag³

2022

CCR

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Introduction: With a wide variety of associated diseases, proper diagnosis and treatment of annular rashes can prove clinically challenging. Case Report: A 53-year-old male presents with a painful, purpuric, annular eruption in addition to multiple risk factors for systemic diseases. An extensive in-patient work-up yielded a suspected diagnosis of IgA-vasculitis despite an atypical presentation. Conclusion: A differential diagnosis for an annular eruption may include cat scratch disease, DRESS syndrome, IgA-vasculitis, among multiple other causes. It is essential to remain vigilant of atypical presentations of disease and to complete a comprehensive history, physical, and workup to ensure optimal patient care.

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COVID-19 and New Onset IgA Vasculitis: A Systematic Review of Case Reports

Cited by 14 publications

References 52 publications

Immunoglobulin A Vasculitis Following COVID-19: A French Multicenter Case Series

Immunoglobulin A Vasculitis Following COVID-19: A French Multicenter Case Series

Viral Infections May Be Associated with Henoch–Schönlein Purpura

Diagnosis of an Annular Rash in an Adult with Multiple Risk Factors: A Case Report

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